International Journal of Research in Dermatology | November-December 2021 | Vol 7 | Issue 6 Page 765
International Journal of Research in Dermatology
Khatun F et al. Int J Res Dermatol. 2021 Nov;7(6):765-770
http://www.ijord.com
Original Research Article
Profile of mean platelet volume, neutrophil - lymphocyte ratio and
platelet - lymphocyte ratio in patient with psoriasis
Fatema Khatun1*, Zakir Ahmed1, Harasit K. Paul1, Zinat Amin1, M. S. Z. Chowdhury2
INTRODUCTION
Psoriasis is a common inflammatory condition of the skin
where concomitant proliferation also happens. Both
genetic and environmental factors are responsible for
psoriasis. Platelets, leukocyte, and endothelial cells
interaction have been evaluated in the inflammatory
process.1 Increased keratinocyte proliferation and
infiltration of T cells, macrophages, and neutrophils seem
to be the main pathophysiology of psoriasis.2 It is also
evidenced by histopathology of psoriatic lesions that a
leukocyte infiltration is seen especially rich in T-
lymphocytes and neutrophils. Coimbra et al have studied
peripheral blood of both psoriatic individual and control
groups and found significantly increased levels of
leukocyte, monocytes, and neutrophils and decreased
levels of lymphocytes.3 In psoriasis, reactive oxygen
species causes the release of cytokines, proteases, and
cationic proteins such as elastase and lactoferrin which
ultimately activate neutrophils. However, thrombocytes
DOI: https://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20214199
ABSTRACT
Background: Psoriasis is a chronic, inflammatory, systemic disease. In response to therapy in psoriasis patients, the
psoriasis area severity index (PASI) is used to evaluate the disease activity. However more objective laboratory tools
should be developed besides PASI. In various inflammatory diseases, mean platelet volume (MPV), neutrophil-
lymphocyte ratio (NLR), and platelet lymphocyte ratio (PLR) are inflammatory biomarkers that are known to be
evaluated. The aim of the study was to assess the frequency of platelet activation and leukocyte infiltration by
measuring MPV, NLR, and PLR.
Methods: This was a case-control observational study conducted at department of dermatology and venereology at
Bangabandhu Sheikh Mujib Medical University from July 2016 to December 2017. A total of 55 psoriasis cases and
55 healthy controls were included according to inclusion and exclusion criteria.
Results: We have investigated a total of 55 psoriasis patients and another 55 age-sex matched control. There were 31
males (56.36%) and 24 females (43.44%) psoriasis patients in the study. The mean age of the patient was 34.27±13.44
years. Mean±standard deviation (SD) value of MPV, NLR, and PLR in our study cases were 9.92±1.21, 4.32±8.53,
and 292.96±88.80 whereas in the case of control values were 9.46±0.636, 4.54±8.51, and 162.26±103.38 respectively.
Conclusions: In conclusion, we suggest MPV is a strong indicator of psoriasis severity. MPV and PLR should be
followed up routinely to take preventive measures against psoriasis-related micro and macro vascular thrombotic
complications.
Keywords: Psoriasis, MVP, PLR, Severity, NLR, PASI
1Department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
2Department of Haematology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
Received: 09 August 2021
Revised: 13 October 2021
Accepted: 14 October 2021
*Correspondence:
Dr. Fatema Khatun,
E-mail: sonda.zayed@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
Khatun F et al. Int J Res Dermatol. 2021 Nov;7(6):765-770
International Journal of Research in Dermatology | November-December 2021 | Vol 7 | Issue 6 Page 766
also suggested to play an important role in the
pathogenesis of psoriasis and the activation of
thrombocytes ultimately increase leukocyte migration in
the skin and release inflammatory cytokines. Evidence
for an in vivo platelet activation, followed by thrombotic
complication development has been established in a
psoriasis patient. Activation of platelets can be done by
various stimuli which are known to mediate the immune-
inflammatory process.4 In inactive condition platelets
remain in a quiescent disc-shaped state. After activation
they become spherical and a pseudopod is formed,
followed by an increment in their size. These activated
platelets show hyper-responsiveness to adenosine
diphosphate (ADP) or collagen-induced aggregation as
they contain denser granules and produce large amounts
of thromboxane A2. Karabudak et al has been
demonstrated that platelet activation, e.g. platelet hyper
aggregability and increased levels of platelet-derived
microparticles and soluble P-selectin is increased with the
severity of psoriasis.5 Measurement of platelet activation
can be done in various ways like measurement of
secretory molecules, such as adhesion proteins,
cytokines, chemokines.6 Mean platelet volume (MPV), a
measure of platelet size, is a valuable indicator for
platelet activation along with function, MPV is one of the
most extensively studied and reported markers of platelet
activation.7 Furthermore, MPV is of low cost, reliable,
easy, and available parameter, estimated with automated
hematology analyzer and also included in routine
complete blood cell count (CBC). Cardiovascular disease,
peripheral artery disease, systemic lupus erythematosus,
systemic sclerosis, rheumatoid arthritis (RA),
osteoarthritis, vascular dementia, and Alzheimer’s
disease, and many other inflammatory diseases cause
significantly increased MPV levels.8 Platelet activation
and aggregation are the basic processes in the
pathophysiology of micro-and macrovascular (e.g.
cerebrovascular, coronary, and peripheral arterial)
disease.9 Altered platelet morphology and function have
been reported in psoriatic patients. Neutrophil-
lymphocyte ratio (NLR) and platelet-lymphocyte ratio
(PLR) are the two new systemic inflammatory
biomarkers.10 To evaluate inflammation in different
chronic inflammatory diseases such as coronary arterial
disease, psoriasis, chronic kidney disease, ulcerative
colitis, gastric cancer, chronic obstructive pulmonary
disease, familial Mediterranean fever, and ankylosing
spondylitis, NLR have been studied exclusively.11 The
NLR is a simple, relatively inexpensive, more available
than any other derived marker. It has established itself as
a good predictor for other multiple cardiovascular
outcomes that reflect an imbalance in the inflammatory
cells and the role of activated neutrophils in
atherogenesis. Moreover, NLR is shown to be an
independent risk factor in cardiovascular diseases.
Central pathology to increase NLR level in psoriasis
patients have increased levels of tumor necrosis factor
(TNF)-α and many other cytokines (IL-6, IL-7, IL-8, IL-
12, IL-17).10 Again, lymphopenia has been observed as
an independent mortality risk in cardiovascular diseases.
NLR is potentially an unrecognized predictor of
subclinical atherosclerosis in patients with psoriasis.
Subclinical atherosclerosis may be predicted by NLR in
patients with psoriasis.12 In many diseases for predicting
inflammation and mortality, the PLR is a novel
inflammatory marker, which is established to be used.
Increased proliferation of megakaryocytic series and
decreased lymphocyte count due to apoptosis causes
altered PLR in the chronic inflammatory process.13
Recent studies show that a high PLR reflects
inflammation, atherosclerosis, and platelet activation.14
Increased PLR has been shown to be associated with
adverse outcomes in cardiovascular diseases and
decreased survival in malignancies such as pancreatic,
colorectal, and endometrial cancers.15 This study would
be done to compare MPV, NLR, and PLR in patients with
psoriasis and healthy individuals and to find out any
relationship of this parameter with disease severity.
Objectives
General objectives
General objective was to assess MPV, NLR and PLR in
patient with psoriasis.
Specific objectives
Specific objectives were to measure MPV, NLR and PLR
in psoriasis patient; to compare mean MPV, NLR and
PLR in psoriasis and healthy control; to categorize
disease severity according to psoriasis area severity index
(PASI) score; and to correlate disease severity with MPV,
NLR and PLR.
METHODS
This was a case-control observational study conducted at
department of dermatology and venereology at
Bangabandhu Sheikh Mujib Medical University
(BSMMU) from July 2016 to December 2017. Study
populations are individuals diagnosed with psoriasis. The
sample populations were extracted via purposive
sampling. Individuals were screened on the basis of the
inclusion and exclusion criteria of the study. Patients with
psoriasis were diagnosed clinically and/or
histopathologically by dermatologists attending the
outpatient department of dermatology and venereology,
BSMMU were recruited as the study population.
Individuals who had apparently no physical complaints
during history taking or presented the clinical finding of
disease during my examination were selected as the
control. The objective and procedure of the study were
explained in both cases and controls in an easily
understandable local language and then the respondents
were signed in written consent form who felt interested to
participate in my study. A detailed history and complete
physical examination and necessary laboratory tests were
Khatun F et al. Int J Res Dermatol. 2021 Nov;7(6):765-770
International Journal of Research in Dermatology | November-December 2021 | Vol 7 | Issue 6 Page 767
carried out. Than 55% with psoriasis and 55 age, sex-
matched healthy control who were free from known
comorbid diseases was enrolled finally for this study
according to the inclusion and exclusion criteria.
Duration of disease was measured in years. The disease
severity of each and every patient was measured by
PASI. The score of PASI usually varies between 0 and
72. PASI score of less than or equal to 10 is classified as
a mild disease, whilst a score of greater than 10 was
considered to be moderate to severe. 2 cc of venous blood
was drawn from each participant and sent to the main
hematology department or clinical pathology, department
of BSMMU for blood complete analysis by an auto-
analyzer. Mean platelet volume was measured as a part of
blood complete analysis and NLR, PLR also was
calculated from the report. Statistical analysis was carried
out by using the statistical package for the social sciences
(SPSS) software version 23.0 for windows. Continuous
data were expressed as the mean±standard deviation (SD)
and categorical variables were expressed as percentages.
All data were processed with student’s independent tests
to compare between psoriatic and healthy individuals.
Spearman correlation coefficient test was used to
correlate MPV, NLR, and PLR with PASI. For all
statistical tests, the p value is less than 0.05 was
considered statistically significant. Prior to the
commencement of this study, the research protocol was
approved by the ethical review committee of BSMMU,
Dhaka.
RESULTS
Table 1 showed the age distribution of the study patients.
Age range of the cases and control was 17 to 67 years and
18 to 64 years respectively. The mean age of cases was
34.27±13.44 years and control was 33±13.26 years.
Table 1: Distribution of the study patients by age
(n=110).
Age in years
Case (n=55)
Control (n=55)
N
%
N
%
15-24
16
29.09
12
21.81
25-34
16
29.09
16
29.09
35-44
9
16.36
11
20.0
45-54
6
10.91
8
14.55
>55
8
14.55
8
14.55
Mean age±SD
34.27±13.44
33±13.26
Range (years)
17-67
18-64
Table 2 showed mean±SD value of MPV, NLR and PLR
in study cases were 9.92±1.21, 4.32±8.53 and
292.96±88.80 where as in case of control values were
9.46±0.636, 4.54±8.51, 162.26±103.38 respectively. Both
the MPV and PLR means are high in case of psoriasis
patient.
Table 2: Mean value of MPV, NLR, PLR in cases and
control (n=110).
Parameter
Case
(mean±SD)
Control
(mean±SD)
MPV
9.92±1.21
9.46±0.636
NLR
4.32±8.53
4.54±8.51
PLR
292.96±88.80
162.26±103.38
The calculated OR is 1.95 and 95% CI 0.9102-4.186. So
patient with psoriasis have higher risk of increased MPV
in comparison to healthy control.
Table 3: Odds ratio for MPV.
Parameter
Cases
Control
Total
MPV increased
35
26
61
MPV not increased
20
29
49
Total
55
55
110
Odds
Odds
ratio
95%
CI
Case
1.75
1.95
0.9102-
4.186
Control
0.8966
The calculated OR is 0.89 and 95% CI 0.34-2.30.
Table 4: Odds ratio for NLR.
Parameter
Cases
Control
Total
NLR increased
10
11
21
NLR not increased
45
44
89
Total
55
55
110
Odds
Odds
ratio
95%
CI
Case
0.222
0.8889
0.3431-
2.3027
Control
0.25
The calculated OR is 1.49 and 95% CI 0.6789-3.271. So
patient with psoriasis have higher risk of increased PLR
in comparison to healthy control.
Table 5: Odds ratio for PLR.
Parameter
Cases
Control
Total
PLR increased
22
17
39
PLR not increased
33
38
71
Total
55
55
110
Odds
Odds
ratio
95%
CI
Case
0.667
1.4902
0.6789-
3.271
Control
0.4474
Table 6 showed there was significant increase in MPV
and PLR in psoriasis patient then healthy control group (p
value was <0.05). NLR has not shown any significant
difference in psoriasis and control group (p=0.895).
Khatun F et al. Int J Res Dermatol. 2021 Nov;7(6):765-770
International Journal of Research in Dermatology | November-December 2021 | Vol 7 | Issue 6 Page 768
Table 6: Comparison of MPV, NLR and PLR in
psoriasis and healthy control (n=110).
Parameters
t value
P value
Significance
status
MPV
2.424
0.019
Significant
NLR
1.33
0.895
Not significant
PLR
6.861
0.000
Significant
Table 7 showed the severity of psoriasis patient on the
basis of PASI score: 65.45% patient had moderate to
severe psoriasis and 34.55% had mild psoriasis.
Table 7: Distribution of psoriasis patient group on
basis of PASI score into mild and moderate to severe
group (n=55).
Severity of psoriasis
N
%
MILD
19
34.55
Moderate to severe
36
65.45
Total
55
100.0
Table 8: Psoriasis severity between male and female
according to PASI score.
Severity of psoriasis
Male
Female
N
%
N
%
Mild
11
35.48
8
33.33
Moderate to severe
20
64.52
16
66.67
Total
31
100.0
24
100.0
Figure 1: Scatter diagram showing correlation with
MPV and PASI score.
Table 9 revealed gender distribution of severity of
psoriasis patient, around two third percent of male and
female suffering from moderate to severe disease
(64.52% and 66.67%), rest one third suffers from mild
disease (35.48% and 33.33% respectively in male and
female).
Table 9 showed only MPV is positively correlated with
severity of psoriasis. MPV increases when disease
severity increased. NLR and PLR had no significant
correlation with disease severity.
Table 9: Severity correlation between MPV, NLR,
and PLR with PASI by Spearman’s correlation test.
Parameter
Rho
P value
Significance level
MPV
0.283
0.036
Significant
NLR
0.060
0.662
Not significant
PLR
0.068
0.624
Not significant
DISCUSSION
Chronic inflammatory condition of the skin is known as
psoriasis. Inflammation results from interactions among
platelets, leukocytes, and endothelial cells.1 Thrombocyte
also aid in the pathogenesis of psoriasis and the activation
of thrombocytes increase leukocyte migration in the skin
and release inflammatory cytokines like tumor necrosis
factor-alpha (TNFα), interleukin-1, interleukin-6,
interleukin-17, interleukin-22, and interleukin-36. None
of these mediators have proved to be reliable biological
markers for psoriasis or its severity. As platelet plays an
important role, platelet and their products have
investigated whether it fits as a biological marker of an
inflammatory condition like psoriasis, systemic lupus
erythematosus, cardiovascular disease, systemic sclerosis,
rheumatoid arthritis, and osteoarthritis. The platelet-
related parameters that have been evaluated so far thus,
include a PLR, CD-62, p-selectin, PDW, and MPV. MPV
has attracted the most attention among these. NLR and
PLR are the two novel inflammatory biomarkers used in
the assessment of systemic inflammation.10 For predicting
inflammation and mortality, these markers are established
to be used in many diseases. Recent studies show that a
high PLR reflects inflammation, atherosclerosis, and
platelet activation.14 NLR may predict subclinical
atherosclerosis in patients with psoriasis.12 This case-
control study was carried out with the aim to see the level
of these inflammatory markers (MPV, NLR, and PLR)
and to see the correlation of these markers with disease
severity. In our study, we have investigated a total of 55
psoriasis patients and another 55 age-sex matched
control. There were 31 males (56.36%) and 24 females
(43.44%) psoriasis patients in the study. The age range of
the psoriasis patient was 17 to 67 years. The mean age of
the patient was 34.27 (SD-13.44) years. Maximum
patients (32) belong to two age groups 16 patients of 25-
34 years and 16 of 35- 44 years. We have found MPV is
significantly higher in comparison to the healthy
individuals (p<0.05) with OR of 1.95(CI=0.9102-4.186)
which is in the agreement with Canpolat et al, Kilic et al,
Karabudak et al, Chandrasekar et al, Kim et al, Asahina
et al, and Ahmed et al showed that MPV was higher in
psoriasis patients in relation to healthy individuals in a
case-control study of a total of 60 subjects.5,16-21 MPV
shows significantly higher by using independent sample
t-test. P value was significant (p=0.001). MPV values
were 8.248±1.150 and 7.442±1.626 in psoriasis and
control group and found significant p<0.001. In a study
Khatun F et al. Int J Res Dermatol. 2021 Nov;7(6):765-770
International Journal of Research in Dermatology | November-December 2021 | Vol 7 | Issue 6 Page 769
done by Kim et al it was found that MPV is not only
increased in psoriasis but also has a positive correlation
with disease severity of psoriasis calculated by PASI
score.22 A total of one hundred and seventy-six (167)
psoriasis patients and 101 healthy controls were observed
in this study. In psoriasis patients, they observed that
PASI, significantly correlated with MPV (r=0.189,
p=0.006). Chandrasekar et al in their case-control study
on 62 psoriasis patients along with age and sex-matched
controls; found that MPV values were higher in patients
as part of overall activation of platelets.18 Karabudak et al
in a study carried out on 20 patients with mild to
moderate psoriasis, found significantly higher values for
MPV in patients compared to controls.23 In another study,
done on 106 patients with psoriasis and psoriatic arthritis
Canpolat et al was able to demonstrate a significantly
higher MPV in psoriasis as well as psoriatic arthritis.16 In
another study, Kilic et al found significantly elevated
MPV in both psoriatic patients and psoriatic arthritis
patients.17 A case-control study was carried out on 50
psoriatic patients and 50 healthy control subjects. Mean
values for MPV were significantly different between the
two groups (control and patients). The MPV values in
male patients showed a strong positive correlation with
the PASI score. They came to the conclusion that rising
MPV may be good indicators of disease severity and
progression. Again psoriasis patients were grouped by
PASI score to see the difference between disease severity
but there was no significant correlation between the
disease activity and mean platelet volume values
(p>0.05). It may be due to the small sample size of 49
only. The study has not found any significance. The mean
MPV values were 8.96±1.03 fL for psoriasis and
8.75±1.07 fL for control groups. No significant difference
was also found between the patients and controls
regarding mean MPV values (p=0.231 and p=0.295, t-test
and Mann Whitney-U test, respectively). They also
measured no correlation between PASI scores and MPV
levels. As they did not found any significance, so
suggested for large population study for further
clarification. In marked contrast to our study, Saleh et al
also failed to see any significant association between
psoriasis and MPV in their study.24 They also failed to
find a link between psoriasis and MPV where the p value
was 0.435. In our study, we have found NLR is not
significantly raised in psoriasis patients in comparison to
the control group. PLR to be increased significantly in
psoriasis patients in relation to control group which
shows the similar result by Asahina et al, and Cereman et
al conducted study over forty-nine patients with psoriasis
and forty-seven controls which reveals NLR levels were
significantly higher in patients with psoriasis than in
healthy controls (p<0.001).11,20 Again psoriasis patients
were grouped by PASI score to see a difference between
disease severity but there was no significant correlation
between the disease activity and neutrophil-lymphocyte
ratio (p>0.05). Asahina et al investigated to evaluate the
clinical significance of novel inflammatory biomarkers,
NLR, PLR and MPV in Japanese patients a significant
correlation was found between NLR and PLR.20 The
NLR-high and PLR-high subgroups exhibited
significantly higher PASI scores compared with the
NLR-low and PLR-low subgroups, respectively. Polat et
al evaluate the relationship between disease activity and
NLR and PLR in patient’s psoriasis through a
retrospective case-control study over 46 patients and a
control group of 46 healthy volunteers.25 NLR and PLR
were significantly elevated in patients with psoriasis
(p=0.0001 and p=0.003, respectively). After PASI
calculation and categorization of psoriasis patient into
mild and moderate to severe psoriasis result shows
positive correlation with NLR, PLR, (r=0.313, p=0.034;
r=0.394, p=0.017; respectively). The investigator
suggested that NLR and PLR are low-cost tests that can
be used to determine the severity of current systemic
inflammation in patients with chronic plaque psoriasis.
PASI score is a worldwide accepted scoring system to
categorize psoriatic patients in mild and moderate to
severe groups. When psoriasis patient is divided under
mild and moderate to the severe group, it found that MPV
correlates with severity of psoriasis. MPV showed a
significant positive correlation in the moderate to severe
group with a p value <0.05 in relation to the mild group.
NLR and PLR were not found to correlate with disease
severity which differs from a study done by Asahina et al
and Polat et al.20,25 MPV positively correlated with
disease severity has been reported by Canpolat et al.16
Same result was also obtained by Kilic et al but weekly
positive.17 Ahmed et al also reported that MPV correlates
significantly with the severity of the disease.26 When the
gender-based analysis was done no significant change in
the overall study result found. Both male and female
group shows significant MPV rises and it also correlated
with disease severity. There are no significant NLR
values in psoriasis but PLR shows significant elevation.
Again PLR is not significantly increasing with disease
severity.
Limitations
The present study had few limitations such as this study
was conducted in a single hospital and had a small
sample size that may not reflect the whole scenerio.
CONCLUSION
In our present study, we have found MPV and PLR
significantly high in psoriatic individuals in comparison
to the control group. PASI score-based disease severity
positively correlates with MPV values. The gender-based
analysis does not alter any result. In conclusion, we
suggest MPV is a strong indicator of psoriasis severity.
MPV and PLR should be followed up routinely to take
preventive measures against psoriasis-related micro and
macrovascular thrombotic complications.
Funding: No funding sources
Conflict of interest: None declared
Ethical approval: The study was approved by the
institutional ethics committee
Khatun F et al. Int J Res Dermatol. 2021 Nov;7(6):765-770
International Journal of Research in Dermatology | November-December 2021 | Vol 7 | Issue 6 Page 770
REFERENCES
1. Gawaz M, Langer H, May AE. Platelets in
inflammation and atherogenesis, J Clin Investig.
2005;115:3378-84.
2. Vanizor Kural B, Orem, Cimsit G. Evaluation of the
atherogenic tendency of lipid and lipoprotein
content and their relationship with oxidant-anti
oxidant system in patients with psoriasis. Clin Chem
Acta. 2003;328:71-82.
3. Coimbra S, Oliveira H, Reis F, Belo L, Rocha S,
Quintanilha A, Figueiredo A, Teixeira F, Castro E,
Rocha-Pereira P, Santos-Silva A. C-reactive protein
and leucocyte activation in psoriasis vulgaris
according to severity and therapy. J Eur Acad
Dermatol Venereol. 2010;24(7):789-96.
4. Kasperska-Zajac A, Nowakowski M, Rogala B.
Enhanced platelet activation in patients with atopic
eczema/dermatitis syndrome. Inflammation.
2004;28:299-302.
5. Karabudak O, Ulusoy RE, Erikci AA, Solmazgul E,
Dogan B. Inflammation and hypercoagulable state
in adult psoriatic men. Acta Derm Venereol.
2008;88:337-40.
6. Hundelshausen V, Weber P. Platelets as Immune
Cells: Bridging Inflammation and Cardiovascular
Disease. Circulation Res. 2007;100(1):27-40.
7. Şenel E, Acar B, Demir E. Mean Platelet Volume: A
Reliable Marker of Inflammation in Recurrent
Apthous Stomatitis and Behçet Disease? Indian
Dermatol Online J. 2017;8(6):468-70.
8. Pauling JD, O'Donnell VB, Mchugh NJ. The
contribution of platelets to the pathogenesis of
Raynaud's phenomenon and systemic sclerosis.
Platelets. 2013;24:503-15.
9. Yilmaz MB, Cihan G, Guray Y. Role of mean
platelet volume in triagging acute coronary
syndromes. J Thromb Thrombolysis.
2008;26:49-54.
10. Uslu AU, Küçük A, Şahin A, Ugan Y, Yılmaz R,
Güngör T, Bağcacı S, Küçükşen S. Two new
inflammatory markers associated with Disease
Activity Score-28 in patients with rheumatoid
arthritis: neutrophil-lymphocyte ratio and platelet-
lymphocyte ratio. Int J Rheum Dis.
2015;18(7):731-5.
11. Çerman A, Karabay E, Altunay İ. Evaluation of
neutrophil-lymphocyte ratio and mean platelet
volume in patients with psoriasis. Med Bull Sisli
Etfal Hosp. 2016;50(2):137-41.
12. Yurtdaş M, Yaylali YT, Kaya Y, Ozdemir M,
Ozkan I, Aladağ N. Neutrophil-to-lymphocyte ratio
may predict subclinical atherosclerosis in patients
with psoriasis. Echocardiography.
2014;31(9):1095-104.
13. Nikolsky E, Grines CL, Cox DA, Garcia E, Tcheng
JE, Sadeghi M. Impact of baseline platelet count in
patients undergoing primary percutaneous coronary
intervention in acute myocardial infarction (from the
CADILLAC trial). Am J Cardiol. 2007;99:1055-61.
14. Balta S, Ozturk C. The platelet-lymphocyte ratio: A
simple, inexpensive and rapid prognostic marker for
cardiovascular events. Platelets. 2015;26(7):680-1.
15. Toprak E, Bozkurt M, Dinçgez Çakmak B, Özçimen
E, Silahlı M, Ender Yumru A, Çalışkan E. Platelet
to Lymphocyte Ratio: A New Inflammatory Marker
For Diagnosis of Preterm Premature Rupture of
Membranes. J Turkish-German Gynecol Assoc.
2017;32(2):31-4.
16. Canpolat F, Akpinar H, Eskioğlu F. Mean platelet
volume in psoriasis and psoriatic arthritis. Clin
Rheumatol. 2010;29:325-8.
17. Kılic S, Reşorlu H, Işık S, Oymak S, Akbal A, Hiz
M, Öğretmen Z. Association between mean platelet
volume and disease severity in patients with
psoriasis and psoriatic arthritis. Adv Dermatol
Allergol. 2017;2:126-30.
18. Chandrasekar T, Yang JC, Gao AC, Evans CP.
Mechanisms of resistance in castration-resistant
prostate cancer (CRPC). Transl Androl Urol.
2015;4(3):365-80.
19. Kim D, Lee J, Kim S, Lee M. Mean Platelet Volume
Is Elevated in Patients with Psoriasis Vulgaris.
Yonsei Med J. 2015;56(3):712.
20. Asahina Y, Nomura M, Ohsuga K. Astrophysical J.
2017;840(25):9.
21. Ahmad Z, Akhtar S, Maan M, Khalid U, Hussain A.
Comparison of mean platelet volume in patients
with psoriasis and healthy individuals. J Pak Assoc
Dermatol. 2014;24(1):1-3.
22. Kim D, Kim J, Hur JK, Been KW, Yoon SH, Kim
JS. Genome-wide analysis reveals specificities of
Cpf1 endonucleases in human cells. Nat Biotechnol.
2016;34(8):863-8.
23. Karabudak O, Ulusoy RE, Erikci AA, Solmazgul E,
Dogan B, Harmanyeri Y. Inflammation and
hypercoagulable state in adult psoriatic men. Acta
Derm Venereol. 2008;88(4):337-40.
24. Saleh H, Attia E, Onsy A, Saad A, Abd Ellah M.
Platelet activation: a link between psoriasisper seand
subclinical atherosclerosis - a case-control study. Br
J Dermatol. 2013;169(1):68-75.
25. Polat G, Ugan RA, Cadirci E, Halici Z. Sepsis and
Septic Shock: Current Treatment Strategies and
New Approaches. Eurasian J Med. 2017;49:53-8.
26. Ahmed S, Yousaf M, Mothana RA, Al-Rehaily AJ.
Studies on wound healing activity of some
euphorbia species on experimental rats. Afr J Tradit
Complement Altern Med. 2016;13(5):145-52.
Cite this article as: Khatun F, Ahmed Z, Paul HK,
Amin Z, Chowdhury MSZ. Profile of mean platelet
volume, neutrophil – lymphocyte ratio and platelet -
lymphocyte ratio in patient with psoriasis. Int J Res
Dermatol 2021;7:xxx-xx.
