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Circadian temporal structure in psoriasis.

The unknown etiopathogenesis of psoriasis and its often unpredictable course, in spite of actual treatment, suggest the search of parameters correlated with the disease that could help to better define and treat these patients. The altered cell turnover of the psoriatic epidermis leads to hypothesize a disturbance or at least a modification of the cellular rhythm of the skin. In order to prove alterations of the circadian temporal structure in psoriasis, we have studied some easily detectable variables, registered at 3-h intervals, in both psoriatic and in healthy control subjects. The control subjects presented statistically significant circadian rhythms of oral temperature, arterial blood pressure, pulse, electrolytes, 17KS, 17-OHCS and uricemia. In the psoriatic group, only a few of these variables present a clearly reproducible circadian rhythm. Moreover these rhythms, when they are demonstrable in the patients, do not show the same circadian acrophases of the control subjects and they are also desynchronized inside the group itself. The alteration in these circadian urinary and haematic rhythms implies that in psoriasis not only the skin is involved: all the circadian structure seems to be perturbed and the cause of the disease should mot be searched only in the epidermis.