D3.94 - Optimizing the Diagnosis and Treatment of Psoriasis Associated with Streptococcal Infection

Psoriasis (Ps) is one of the most common chronic dermatoses, affecting 3 to 7% of the global population, according to various authors. Being a genetically determined immunopathological disease, psoriasis is characterized by hyperproliferation of epidermal cells, impaired differentiation of keratinocytes, and immune system dysfunction with the formation of immune-dependent cytokines and mediators.

All patients in the main group and the control group underwent a comprehensive clinical and laboratory examination, including:

Collection of family history/anamnesis and disease history; Physical examination: To determine the severity of the pathological lesion, a standardized method for assessing PASI (Psoriasis Area and Severity Index) was used. Clinical and biochemical blood tests; CMSM (Chromato-Mass Spectrometry of Microbial Markers) of blood, skin, and throat swabs. The method is highly sensitive and rapid (requiring only 3 hours for a complete analysis cycle).

Blood analysis—ASLO (anti-streptolysin O) and ANCA (antineutrophil cytoplasmic antibodies). Examinations - 1 Stage Results: Analysis of the laboratory results revealed the following: 28% of patients (n=7) showed a slight increase in ASLO levels (more than 200); 28.5% (n=8) revealed Strep. viridans or Strep. aureus cultured in 10, 4-5 degrees; and ANA level was negative in all patients (100% of cases). Thus, the clinical significance of such indicators as ASLO, ANA, and levels of Strep. viridans or Strep. aureus at psoriasis (Ps) is extremely low.

This prompted us to use more sensitive research methods to investigate the role of Strep. pyogenes in the pathogenesis of Ps and its identification.

Using the chromatographic mass spectrometry method of microbial markers (CMSM), a disruption of micro biocenosis was revealed in patients with Ps, characterized by an increase in the concentration of 6 opportunistic pathogenic microorganisms (p < 0.05): coccal microflora (Streptococcus spp., Staphylococcus aureus); microorganisms of the Clostridia group (intestinal flora: Clostridium perfringens, Clostridium propionicum).

Microorganisms causing purulent skin lesions (Propionibacterium acnes); fungi of the Candida genus; increase in endotoxin levels (p < 0.05); and a normal concentration of lactobacilli