Stimulation of the hypothalamic-pituitary-adrenal axis with corticotropin releasing hormone in patients with psoriasis

Abstract

Objective: Psychocutaneous diseases constitute a large proportion of psychosomatic disorders, with psoriasis being one of the most typical cases. Though alteration of Hypothalamic-Pituitary-Adrenal (HPA) axis function has been suggested as underlying several psychiatric disorders and psychosomatic diseases, there is little evidence of reduced response of the HPA axis in psoriasis after psychosocially induced laboratory stress. The aim of the study was to investigate any alteration of the neuroendocrine profile of psoriatic patients.

Design: The psoriatic patients (n=24) and the same number of matched controls underwent a CRH test which consisted of 100 microg h-CRH IV infusion and drawing of blood samples at 0 min and at 15, 30 and 60 min post h-CRH for measurement of plasma ACTH and cortisol concentration.

Results: Mean plasma ACTH and cortisol levels in both groups increased during the 60-min CRH test without significant difference. The total secretion of plasma ACTH and serum cortisol estimated as Area Under the Curve did not show significant difference between the groups either.

Conclusions: Contrary to previous studies no particular neuroendocrine profile of HPA axis responsiveness was identified in psoriatic patients.