the rise of staphylococcal super antigens in psoriatic patients: a case-control study

background: staphylococcus aureus, the major virulence factor of hospital and community acquired infections, secretes numerous exotoxins (super antigens), which may affect immunological and inflammatory status in psoriatic skin lesion. objectives: this study is designed to compare the s. aureus super antigens level in sera of psoriatic patients with normal cases (nevus). patients and methods: a case control study was performed in dermatology ward of rasoul hospital in tehran, ir iran (2008 - 2010). staphylococcal super antigens (entrotoxin a, b, d and tsst1) were measured in serum of 41 psoriatic patients and 28 normal persons (nevus) by elisa. chi square values (ci 95%, p value < 0.05) were calculated for all categorical variables. results: in this study 63.4% (26) of cases were male, 36.6% (15) were female. age ranged from 4 months to 64 years old, with a mean age of 33.7 ± 15.4 years. type of skin disease in cases: 20% (8) were inflicted by the gutate form of the disease; 59% (23) with chronic plaque psoriasis (cpp), 7.7% (3) with erythrodermic and 12.8% (5) had other types of the disease (plaque, pustular, inverse). tsst (toxic shock syndrome toxin) was detected in 47% (20/41) of cases and in 6% (1/28) of the controls with a significant difference. (p value = 0.000) entrotoxins (a, b, d) were detected in the sera of 48.8% (21/41) of cases; and only 6 %( 1/21) of controls, showed significant differences (p value = 0.000) positive tsst was more common in spring, and correlates with cpp type of psoriasis, but not related to patient`s gender and age. conclusions: in this study, s. aureus were 25 times more in psoriatic patients. super antigens should be first detected in the serum samples; if negative, the skin lesions should be examined by pcr especially in chronic types of disease. adding the antibiotics against s. aureus to other conventional treatments might be helpful. it has a more important and significant role in children with acute infection.