Platelet Count, Mean Platelet Volume, and Red Cell Distribution Width as Markers for Psoriasis Severity

Abstract

Background: Psoriasis is a chronic, inflammatory skin condition that is growing in prevalence globally. Routinely available options to assess psoriasis severity and progression are limited. More options are needed to monitor disease progression as therapeutic management is based on disease severity. 
Objectives: This study evaluates the usage of complete blood count components (CBC) including platelet count, mean platelet volume (MPV), and red cell distribution width (RDW) as hematological markers for assessing psoriasis severity. 
Materials and Methods: In this cross-sectional study of 120 patients with psoriasis, disease severity was assessed using the PASI score followed by a blood draw to determine whether correlations existed between each marker and PASI score. 
Results: A significant, positive correlation was found between total platelet count and PASI while no such correlation was found in MPV and RDW. When stratifying for age, duration of disease, sex, and body parts involved, we found intriguing relationships and offer potential explanations for their occurrence. 
Conclusion: Our findings suggest that hematological parameters MPV, platelet count, and RDW found in the CBC are useful in identifying psoriasis severity to some extent. We foresee the use of RDW, MPV, and platelet count biomarkers as a complement to the PASI score in assessing severity for psoriasis patients, while also as a gauge for likelihood of developing comorbidities such as cardiovascular disease. 

J Drugs Dermatol. 2022;21(2): doi:10.36849/JDD.6127 

The prevalence of dermatologic disease is rising in Southeast Asia. As such, clinicians in this region search to identify risk factors and diagnostic markers to better understand these conditions and develop appropriate diagnostic criteria.¹ One such condition includes psoriasis, a chronic inflammatory skin disease affecting nearly 2% of individuals of European descent and 0.2â€"4% of the world population.² The prevalence of psoriasis in dermatological departments in Southeast Asia was reported to be nearly 3.8%.¹ One hallmark of psoriasis is its tendency to wax and wane, with flares related to systemic and environmental factors including stress and infection. Thus, the prevalence of psoriasis may be underreported in certain areas due to its undulating nature.³ 

Genetics and immunological mechanisms are thought to play a significant role in psoriasis.⁴Furthermore, many comorbidities are associated with symptom onset and progression to severe disease. Psoriasis has been associated with metabolic syndromes including obesity, dyslipidemias, diabetes, hypertension, and cardiovascular disease (CVD). Patients with psoriasis may have hematological, biochemical, and immunological abnormalities characterized by markers varying amongst psoriasis subtypes.⁵ Determining which of these indicators are associated with psoriasis may improve diagnostic confidence, help classify between various subtypes, serve as a prognostic marker, better prepare the clinician for treatment options, and aid in monitoring progression of disease. Two hematological markers which can reflect the inflammatory status of psoriasis patients include red blood cell distribution width (RDW) and mean platelet volume (MPV).⁶ 

The objective for this study was to find the correlation of platelet count, MPV, and RDW with severity of disease in psoriasis patients as measured by the Psoriasis Area and Severity Index

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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