Background: Dysfunctional apoptosis has an important role in the development of several skin diseases.Psoriatic keratinocytes possess an enhanced ability to resist apoptosis, which might be one of the key pathogenetic mechanisms in psoriasis.P53, bcl-2 and caspase-3 are proteins which control apoptosis.Several studies have evaluated the expression of these two proteins in the psoriatic skin, but the results are controversial.Methods: Eighty-five cases of psoriatic skin biopsies were studied, and the grade of bcl-2, p53 and caspase-3 immunostaining was correlated with the histopathological indices of severity.Results: Bcl-2 expression in the epidermis strongly correlated with the expression in the basal cells and lymphocytes (P-0.001 and 0.035).There was no correlation with epidermal hyperplasia or with p53 expression in the three compartments.Bcl-2 expression in the basal layer correlated with the p53 expression in the epidermis (P-0.027),basal layer (P-0.015) and the lymphocytes (P-0.034).There was a strong correlation among the p53 expression in all the compartments.There was also a weak correlation of the p53 expression in the epidermis with the epidermal hyperplasia (P-0.042).High caspase-3 H score was significantly in favour of psoriatic group in comparison with the control group.On the contrary, in the dermis, caspase-3 was significantly higher in skin adnexa while completely absent in the psoriatic group.Strong caspase-3 expression was significantly in favour of high PASI score, early onset lesions and lesions in the extremities.Significant positive correlation was found between caspase-3 percent and PASI score (r = +0.53,P-value = 0.03).Conclusions: Bcl-2 does not appear to play an important role in the apoptotic process in psoriasis.In contrast, it is likely that p53 has a far more important role to play.Caspase-3 over expression in the psoriatic lesion proposes a potential role in the pathogenesis of psoriasis.Positive correlation between the caspase-3 expression and the early onset psoriatic lesion located in the extremities implies a possible poor prognostic impact of caspase-3 over expression. | Cytokine gene polymorphisms and their relation with NFκB expression and histopathological features in psoriasis