Effects of photochemotherapy on cardiometabolic markers in Eastern patients with psoriasis, with and without atherosclerosis: a pilot comparative study

Background Psoriasis and unstable atherosclerotic plaques share common inflammatory pathways. Little is known about the effects of psoralen ultraviolet A (PUVA) photochemotherapy on cardiometabolic risk factors and atherosclerotic plaques in patients with psoriasis. Objective To investigate the effects of 36 sessions of PUVA on several cardiometabolic biomarkers in patients with psoriasis with and without atherosclerosis. Patients and methods A comparative clinical trial screened 91 patients with chronic plaque psoriasis for eligibility. Fifty patients and 15 individuals for control of laboratory values were included. In all, 27 patients were allocated to either atherosclerosis (A) or nonatherosclerosis group (B) based on duplex ultrasonography. Psoriasis area and severity index (PASI), BMI, waist circumference, arterial blood pressure, high-sensitive C-reactive protein, oxidized low-density lipoprotein, lipid profile, and fasting/postprandial blood glucose were assessed before and after 36 sessions of PUVA. Results Before–after treatment comparison revealed that, in group A, three biomarkers improved along with PASI: triglycerides, cholesterol, and systolic blood pressure, while in group B, PASI was the only parameter that significantly improved. PASI percent reduction correlated positively with both systolic blood pressure, cholesterol percent reduction, and low-density lipoprotein percent change in group A. Atherosclerotic plaques in group A showed no significant change after treatment. Conclusion PUVA photochemotherapy can have an added benefit in patients with psoriasis and atherosclerosis in comparison with patients without atherosclerosis. Testing the atheroprotective potential of different ultraviolet wavelengths in long-term studies is warranted.