Psoriasis severity and hypothalamic-pituitary-adrenal axis function: results from the CALIPSO study

Area of Science:

• Endocrinology
• Dermatology
• Psychoneuroimmunology

Background:

• Psoriasis is a chronic inflammatory skin condition impacting quality of life.
• It is frequently associated with psychological distress, including stress, anxiety, and depression.
• The hypothalamic-pituitary-adrenal (HPA) axis is a key stress response system.

Purpose of the Study:

• To investigate the association between HPA axis activity and psoriasis severity.
• To explore correlations with daily life stress, anxiety, and depressive symptoms in psoriasis patients.

Main Methods:

• Salivary cortisol was measured at five time points in 102 psoriasis patients.
• Cortisol levels were assessed immediately upon awakening, 30, 60 minutes after, at 2:00 pm, and at bedtime.
• Pearson's correlation coefficient was used to analyze associations with clinical and psychopathological variables.

Main Results:

• A significant direct correlation was found between bedtime salivary cortisol levels and psoriasis severity, as measured by the Psoriasis Area and Severity Index (PASI; r=0.39, P<0.001).
• No significant correlations were observed between other cortisol measurements or with other clinical and psychopathological variables.
• These findings suggest potential HPA axis dysfunction in psoriasis.

Conclusions:

• Bedtime cortisol levels correlate with psoriasis severity, indicating a potential role for HPA axis dysregulation in the disease.
• Further research, including control groups, is needed to confirm these findings and understand HPA axis activity in psoriasis compared to healthy individuals.