Deleterious Dilemma Of Hyperuricemia In Psoriasis And Psoriatic Arthritis - Urate Lowering Drugs Rescue !!

Abstract

Psoriasis is a chronic auto immune skin disease. Hyperuricemia is frequently associated in patients with Psoriasis and Psoriatic arthritis. Furthermore it can complicate with Cardio vascular Disease and Metabolic Syndrome. Psoriasis is commoner in obese persons that can also result in the development of hyperuricemia. Hyperuricemia can result in gouty arthritis. All Psoriatic patients to be monitored for hyperuricemia and early intervention of the same through therapeutic regimens can avert the development of metabolic syndrome and coronary artery diseases. Psoriatic arthritis (PsA) denotes the articular component of the systemic psoriatic disease and the extra-cutaneous disorder most frequently found in patients with Psoriasis. Apart from the involvement of the joints, PsA is associated with several metabolic disorders like insulin resistance, hypertension, diabetes and hyperuricemia. Hyperuricemia in Psoriasis and PsA is due to the increased cellular turnover characterized typical of this disorder . The hyperproliferation of keratinocytes culminates in the accelerated nucleic acid catabolism and enhanced uric acid synthesis. However, hyperuricemia might also derive from an increased uric acid production in the liver. The overwhelming cytokines synthesis in PsA, in particular IL-17, can affect the liver, leading to hepatic complications such as non-alcoholic fatty liver disease. Psoriatic patients treated with allopurinol showed marked improvement of skin lesions and decreased Serum Uric Acid in most cases. The effects of the febuxostat therapy in patients with Psoriasis, Psoriatic Arthrits and hyperuricemia led to the decreased serum levels of inflammatory markers such as IL-6, IL-17, and TNF-α.