The role of angiogenesis in psoriasis: An analysis of vascular endothelial growth factor (VEGF) and CD31 expression

BACKGROUND: Psoriasis is a chronic inflammatory disease affecting the skin and multiple organ systems, and is associated with significant comorbidities such as cardiovascular disease, metabolic syndrome, and depression with no known cure. Angiogenesis is thought to play a key role in its pathogenesis. AIM: To demonstrate the expression of vascular endothelial growth factor ( VEGF ) and CD31 in psoriasis compared to psoriasiform lesions, and to evaluate the role of angiogenesis in psoriasis. MATERIALS AND METHODS: A total of 52 skin biopsies (39 psoriasis and 13 psoriasiform lesions) were analysed using Hematoxylin and Eosin (H and E) staining and immunohistochemistry for VEGF and CD31 expression. RESULTS: Strong VEGF expression (>50%) was observed in 43.6% of psoriasis cases, whereas 61.5% of psoriasiform lesions showed weak expression ( P = 0.018). The mean microvessel density ( CD31 expression) was significantly higher in psoriasis (10.08 ± 4.47) compared to psoriasiform lesions (7.87 ± 2.29; P = 0.026). A positive correlation was found between VEGF expression and CD31 (Pearson's r = 0.295). CONCLUSION: These findings highlights the role of angiogenesis in psoriasis, marked by the increased expression of VEGF in suprabasal keratinocytes and CD31 in superficial dermal vessels, thus underpinning the use of anti-angiogenic therapy for disease management in psoriasis.