الفهرس 
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Abstract
Psoriasis is a chronic immune-mediated inflammatory disease, affecting 2-3% of population worldwide. There are three major forms of psoriasis therapy – topical therapy ; phototherapy ; and systemic therapy. Acitretin is an oral retinoid approved for the treatment of psoriasis. It acts by modulating the proliferation of epidermal keratinocytes. Gonadotropins are glycoprotein polypeptide hormones secreted by gonadotropic cells of the anterior pituitary, including FSH and LH. These hormones are central to the complex endocrine system that regulates normal growth, sexual development, and reproductive function. Some investigations reported that patients with psoriasis had higher levels of FSH and LH compared with healthy controls. This quasi-experimental (pre-post) study was carried out to evaluate the effect of acitretin administration on gonadotropins (FSH) and (LH) in female psoriatic patients. Our study was carried out on 31 female psoriatic patients who were recruited from the Dermatology outpatient clinic of Dermatology, Andrology and STDs department, Mansoura University Hospital. Including, female psoriatic patient in whom acitretin was indicated, their age ranged from (18-60). Excluding, patients with endocrinal diseases, on hormonal treatment, or had contraindications for acitretin administration like hepatic diseases, high serum cholesterol and triglycerides, and bone marrow suppression. Each participant was subjected to: 1) Full history taking including progression of the lesions, previous medications or intervention. 2) Complete general and dermatological examinations. 3) Psoriasis Area and Severity Index (PASI score) estimation before treatment. 4) Serum cholesterol, serum triglyceride and liver function test. 5) Fasting morning blood sample to assess serum levels of FSH and LH before start of acitretin administration. The same assessment was done again after 2 months of acitretin administration. Dose of acitretin was 0.5 mg/kg/day, and the assay of (FSH and LH) hormones was done using ELISA test. Our study results have revealed that the mean ages of psoriasis patients were 50.94 ± 10.3 years with range between 35 and 70 years. There were 14 cases (45.2%) with age < 40 years and 17 cases (54.8%) with age ≥ 50 years. The mean duration of psoriasis disease was 4.92 ± 3.71 years with range between 1 and 15 years. The mean PASI was 27.51 ± 9.38 with range between 12 and 47.4. Regarding the used dose of acitretin in the studied cases, 10 cases (32.3%) responded to a dose of 35 (mg/kg), 18 cases (58.1%) responded to a dose of 50 (mg/kg) and just 3 cases (9.7%) required a dose of 75 (mg/kg). Regarding the state of menopause among the included cases, there were 4 cases (12.9%) in premenopausal follicular phase, there were 3 cases (9.7%), there were 2 cases (6.5%) in premenopausal luteal phase and there were 22 cases (71%) in postmenopausal phase. Both of FSH showed only slight decrease (34.06 ± 23.34 to 33.28 ± 22.91mIU/L) and serum LH level showed slight increase (22.86 ± 14.43 to 23.96 ± 14 mIU/L) from before acitretin treatment to after treatment, with no statistically significant difference. There was highly statistically significant difference in both of FSH and LH level before and after treatment between the included females according to the state of menopause. The highest level of the hormone was found in the postmenopausal females before and after treatment. FSH and LH levels were statistically significantly higher in the cases with age ≥50 years as compared with the cases with age <50 years before and after treatment. FSH levels were statistically significantly higher in the cases with disease duration ≥5 years as compared with the cases with disease duration <5 years before and after treatment. However, the LH levels showed no statistically significant change in the cases with disease duration ≥5 years as compared with the cases with disease duration <5 years before and after treatment. The degree of change of FSH and LH levels didn’t show a statistically significant difference between the cases according to the responding dose or onset of the disease. There was a statistically significant positive correlation between the PASI score and only the dose of acitretin. While, there was no statistically significant correlation between the PASI score of the included case and their ages, disease duration, FSH before or after treatment, LH before or after treatment.