Prognostic Value of Systemic Inflammation Biomarkers in Patients With Psoriasis

BACKGROUND: Standard systemic inflammation markers such as high-sensitivity C-reactive protein, erythrocyte sedimentation rate, and leukocyte count correlate only moderately with psoriasis severity. Therefore, novel in vivo measures of inflammation are essential to understand the extent of systemic inflammation in psoriasis. Currently, limited data are available on the role of emerging composite systemic inflammation indices such as SIRI, MLR, NLR, SII, PLR, and AISI in psoriasis monitoring. AIM: To evaluate the role of novel hematologic biomarkers of systemic inflammation in patients with various forms of psoriasis. METHODS: All patients with psoriasis and psoriatic arthritis included in the study had systemic inflammation indices calculated. The extent and severity of psoriatic skin involvement were assessed using the standardized PASI score. RESULTS: The study group included 77 patients with psoriasis: 33 women (42.9%) and 44 men (57.1%), with a mean age of 41.3 ± 13.4 years. The median PASI score was 10.8 (3.2; 15.3). Of these, 58 patients (75.3%) had only cutaneous manifestations, and 19 (24.7%) had psoriatic arthritis. The diagnostic significance of SIRI, MLR, NLR, SII, PLR, and AISI varied among patients. Psoriatic nail dystrophy was associated with elevated SII (p = 0.005), NLR (p = 0.053), and PLR (p = 0.037) indices in the psoriasis subgroup. Scalp involvement was significantly associated with higher MLR values (p = 0.049). In patients with cutaneous psoriasis only, the mean SIRI was twice the reference value. The mean AISI was 1.5 times the reference value in patients with both psoriasis and psoriatic arthritis. Notably, AISI was significantly higher in patients with severe psoriatic arthritis (PASI 20–30) than in those with severe psoriasis. CONCLUSION: Composite hematologic indices of systemic inflammation are sensitive tools for assessing and predicting psoriasis severity. Elevated SIRI and AISI are prognostically relevant for early detection of psoriatic arthritis. Increased SII, NLR, and PLR are significantly associated with the development of nail dystrophy, while elevated MLR is linked to scalp involvement. © 2025 Elsevier B.V., All rights reserved.