THE ROLE OF THE CLINICAL INDICATOR NEUTROPHIL-LYMPHOCYTE RATIO (NLR) IN VULGAR AND PUSTULAR PSORIASIS
DOI:
https://doi.org/10.52340/jecm.2026.02.12Keywords:
Vulgar psoriasis, pustular psoriasis, NLR, BiomarkerAbstract
Psoriasis is one of the most common chronic skin diseases. The leading immunological mechanism in the pathogenesis of psoriasis is: Th1/Th2 cellular autoreactivity to a still unknown antigen.
The aim of our study was to determine the neutrophil-lymphocyte index (NLR) in the blood of patients with vulgar and pustular (rare, but more severe) psoriasis, evaluation of the potential of blood cell relative indices in clinical practice for psoriasis. NLR reflects the balance of the body's inflammatory and immune responses: neutrophils are typically associated with acute inflammation, while lymphocytes are associated with regulatory and chronic immune processes. An increase in NLR often indicates systemic inflammation, immune imbalance, or disease activity, which is why it is widely used as a prognostic or diagnostic indicator in various pathologies.
According to our results, in patients with pustular psoriasis, the neutrophil-lymphocyte index is significantly higher, reflecting an intense systemic inflammatory response and a tendency for neutrophil dominance. In the case of psoriasis vulgaris, a moderate increase in NLR corresponds to a chronic, but relatively less active inflammatory process. Accordingly, the neutrophil-lymphocyte index can be used as an additional biomarker that may reflect the form of the disease and the degree of inflammatory activity in patients with psoriasis.
Downloads
References
Parisi R., Symmons D. P. M., Griffiths C. E. M., Ashcroft D. M. (2013). Global epidemiology of psoriasis: A systematic review of incidence and prevalence of psoriasis. Journal of Investigative Dermatology, 133(2): 377–385
Rani R, Luger TA. Inverse psoriasis: From pathophysiology to targeted treatment. Dermatol Ther. 2021;34(1):e14501.
M. A. Lowes, C. B. Russell, D. A. Martin, J. E. Towne, and J. G. Krueger, “The IL-23/T17 pathogenic axis in psoriasis is amplified by keratinocyte responses,” Trends in Immunology, 2013; 34(4):174–181.
Fitzpatrick’s Dermatology in General Medicine. 9th ed. McGraw-Hill.
Bolognia JL, et al. Dermatology. 4th ed. Elsevier, 2018.
Schon MP, Boehncke WH, Brocker EB. Psoriasis: clinical manifestations, pathogenesis and therapeutic perspectives. Discov Med.2005; 5(27):253-258.
Zahorec R. Ratio of neutrophil to lymphocyte counts—rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy. 2001;102(1):5-14.
Briggs C. Quality counts: new parameters in blood cell counting. Int J Lab Hematol. 2009;31(3):277-297
Dinh KM, Warstadt NM, Uyeki TM. Immune suppression and lymphopenia in influenza infections: pathogenesis and implications. Clin Microbiol Rev. 2020;33(3):e00064-19.


