Trace elements in psoriasis presentation and treatment

This systematic literature review examines the relationship between psoriasis and trace metals to elucidate the pathogenesis of this condition, and to explore their potential use as a new route of treatment. Searches were primarily conducted in three databases: PubMed, Scopus, and Embase. The initial search resulted in over 100 articles which were manually assessed by the researchers to determine relevancy. Articles were only included if they were published within the last 12 years and were held to the standards of Boote and Biele's Literature Review Rubric to assess their quality. Of the relevant articles included in this study, the following three elements were largely discussed: calcium, magnesium, and zinc. Although not a trace metal, the macromolecule, calcium, was found to regulate the differentiation and proliferation of cells involved in the pathogenesis of psoriasis. Magnesium is thought to have an indirect relationship with psoriasis due to its role in Vitamin D absorption. Additionally, the zinc ion protects against oxidative stress, which is theorized as a mediator of the inflammatory response central to the pathogenesis of psoriasis. Many studies also investigated the serum levels of these elements to see if they were correlated with the severity of the condition. The serum levels of both calcium and zinc were found to have a negative correlation with the amount of surface area involved during a plaque psoriasis flare. These results indicate a potential benefit from evaluating the serum levels of these key modulators in patients. The lab values would indicate any deficiencies or imbalances, which can assist in a physician's ability to determine an individualized and targeted treatment course. Findings from this review consolidate the information currently available, and support the idea that psoriasis is influenced by trace metals. While there is still limited discussion on the evaluation of this relationship, the reviews findings demonstrate that additional comprehensive research would be warranted.