Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Dermatology and Venerology

Background: Psoriasispatients have an increased prevalence of cardiovascular risk. Various studies have shown that systemic treatments for psoriasismay significantlydecreasecardiovascularrisk. Objective: to study the effect of methotrexate (MTX) alone versus methotrexate and vitamin D (MTX +Vit D) on the cardiovascular risk of psoriatic patients. Patients and methods: This study included 30 patients with moderate to severe psoriasis vulgaris. All patients were assigned to Mtx with dose 0.2-0.5mg/kg/week. Fifteen of the patients were randomly assigned to Vitamin D injections monthly for three months in addition to Mtx. Clinical and laboratory assesments were performed including: blood pressure, extent of lesions, PASI score, PDI score, vitamin D levels, lipid profile, albumin/creatinine ratio, carotid duplex and high sensitive c- reactive protein before and after 3 months of treatment. Results: Both groups showed statistically significant improvement in the extent of lesions, PASI scoring, PDI and diastolic B.P. Also, reduction in systolic B.P and mean thinning in CIMT were reported in both groups, but only statistically significant in MTX group. Non significant reduction in HsCRP was reported in both groups. Also, an increase in the triglycerides mean level has been detected in both groups, however, this increase was only statistically significant in the Mtx group. Moreover, we reported non-significant decrease in LDL mean level and slight increase in cholesterol and HDL mean levels in the Mtx group while decrease in LDL and cholesterol mean levels with no change in HDL mean level in Mtx+vit D group

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