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Updated: Jul 18, 2026
Measuring Psoriasis Severity at Home
Published on: March 1, 2024
Plasma homocysteine and folate levels in patients with chronic plaque psoriasis
M Malerba1, P Gisondi, A Radaeli
1Department of Internal Medicine, First Medical Division, University of Brescia, Spedali Civili, Brescia, Italy. malerba@med.unibs.it
Insights
Patients with psoriasis show higher homocysteine and lower folate levels, increasing cardiovascular risk. Managing these factors may benefit psoriasis patients.
Area of Science:
- Dermatology
- Cardiovascular Medicine
- Nutritional Science
Background:
- Hyperhomocysteinemia is a known cardiovascular disease risk factor.
- Severe chronic plaque psoriasis is linked to increased thrombotic event mortality.
- This study investigates psoriasis patients without acquired hyperhomocysteinemia risk factors.
Purpose of the Study:
- To examine the relationship between plasma homocysteine and folate levels and psoriasis severity.
- To assess these levels in psoriasis patients compared to healthy controls.
- To identify potential links between nutrient levels and disease activity.
Main Methods:
- A case-control study involving 40 psoriasis patients and 30 healthy controls.
- Exclusion of participants with conditions causing acquired hyperhomocysteinemia.
- Measurement of plasma homocysteine and folic acid, correlated with Psoriasis Area and Severity Index (PASI).
Main Results:
- Psoriasis patients had significantly higher homocysteine (16.0 vs. 10.4 µmol/L) and lower folate levels (3.6 vs. 6.5 nmol/L).
- Plasma homocysteine correlated directly with PASI scores and inversely with folate levels.
- Folic acid levels showed an inverse correlation with PASI; Vitamin B6 and B12 levels were normal.
Conclusions:
- Psoriasis patients exhibit a tendency towards hyperhomocysteinemia, potentially increasing cardiovascular risk.
- Dietary interventions targeting homocysteine may be crucial for managing moderate to severe psoriasis.
- Further research into nutritional interventions for psoriasis management is warranted.
Background:
Hyperhomocysteinaemia is a well-known risk factor for cardiovascular diseases. Patients with severe chronic plaque psoriasis have a higher risk of death due to arterial and/or venous thrombosis.
Objectives:
To investigate the relationship among plasma homocysteine and folate levels and severity of chronic plaque psoriasis in a selected cohort of patients with psoriasis without known risk factors for acquired hyperhomocysteinaemia.
Methods:
We performed a case-control study in 40 patients with chronic plaque psoriasis and 30 age- and sex-matched healthy controls. Cases and controls were selected excluding individuals with conditions or diseases associated with acquired hyperhomocysteinaemia, and were also asked to stop alcohol and coffee consumption for 1 week before blood sampling. The plasma levels of homocysteine and folic acid were measured and were correlated with the severity of psoriasis (Psoriasis Area and Severity Index, PASI).
Results:
Patients with psoriasis had plasma homocysteine levels higher than controls (mean +/- SD 16.0 +/- 5.6 vs. 10.4 +/- 4.7 micro mol L(-1); P < 0.001). Conversely, folic acid levels were lower in patients with psoriasis compared with controls (mean +/- SD 3.6 +/- 1.7 vs. 6.5 +/- 1.7 nmol L(-1); P < 0.001). Plasma homocysteine levels in patients with psoriasis correlated directly with disease severity (PASI) and inversely with folic acid levels. Plasma folic acid levels were inversely correlated with the PASI. No abnormalities of plasma vitamin B(6) and B(12) were found.
Conclusions:
Patients with psoriasis may have a tendency to hyperhomocysteinaemia, which may predispose to higher cardiovascular risk. Dietary modification of this risk factor appears relevant to the global management of patients with moderate to severe psoriasis.
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