الفهرس 
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Abstract
Psoriasis is Th1/Th17 mediated chronic inflammatory disease (Lockshin et al., 2018). Psoriasis derives from a complex interaction between genetic background, environmental factors and immune response which leads to a chronic, low-grade inflammatory status (Orciani et al., 2011). A growing body of evidence from clinical and epidemiological research has revealed an association between psoriasis and cardiovascular (CV) diseases (Miller et al., 2013). The mechanisms underlying this association are unclear. Some have speculated that Th1/ Th17mediated chronic inflammation is an integral part of psoriasis pathogenesis, also plays a part in the development of atherosclerosis (Lockshin et al., 2018). Other studies have suggested that hyperhomocysteinaemia might account for the increased susceptibility to CV diseases in patients with psoriasis (Giannoni et al., 2015). Hyperhomocysteinaemia is a medical condition characterised by an abnormally high level (above 15 μmol/L) of homocysteine in the blood (Guo et al., 2009). Hyperhomocysteinaemia is a well-known risk factor for atherosclerosis (Debreceni and Debreceni , 2014) and venous thrombosis (Giannoni et al., 2015). Homocysteine can mediate pathogenesis of CVD by several mechanisms such as adverse effects on vascular endothelium, smooth muscle cells with alterations of arterial structure and function. Some of the presumed mechanisms include increase in proliferation of vascular smooth muscle cells, endothelial dysfunction, oxidative damage and deterioration of arterial wall elastic tissue (Nilajkar et al., 2018). Homocysteine metabolism is dependent in part on folate and vitamin B12 so deficiency of these vitamins may lead to be elevated homocysteine levels, which in turn impair endothelial function (Debreceni and Debreceni,2014). The Aim of this study: This study was conducted to investigate the relationship between homocysteine, folic acid and vitamin B12 levels and psoriasis vulgaris through : 1.Estimation of serum levels homocysteine, folic acid and vitamin B12 in psoriasis vulgaris patients in comparison to controls. 2.Searching for any correlation between the serum levels of homocysteine, folic acid and vitamin B12 and severity of psoriasis as defined by PASI score. Materials and methods: The study included 80 subjects who were distributed into two groups; • group A (Cases group) : included 50 patients with chronic plaque psoriasis vulgaris. • group B (Control group): included 30 non psoriatic healthy age and sex matched subjects. Results : The current revealed that : The mean folic acid level in the psoriasis group was statistically significantly lower as compared with the control group. The mean vitamin B12 level in the psoriasis group was statistically significantly lower as compared with the control group. The mean homocysteine level in the psoriasis group was statistically significantly higher as compared with the control group .There was a statistically significant negative correlation between homocysteine and folic acid level. Also, there was a statistically non-significant negative correlation between homocysteine and vitamin B12 level. On the other hand, there was a statistically non-significant positive correlation between folic acid and vitamin B12 level. There were no statistically significant correlation between homocysteine , folic acid, vitamin B12 levels and either disease severity by PASI score or the duration of the psoriasis Conclusion : The current study indicates that hyperhomocysteinaemia , decreased serum folate levels, and decreased serum B12 levels are common in patients with psoriasis. Serum homocysteine level was negatively correlated with serum folate level. No significant correlation was found between psoriasis severity and serum levels of homocysteine, folic acid, or vitamin B12. Hyperhomocysteinaemia can be considered as an independent risk factor for CVD in psoriasis patients that does not correlate with the severity of the disease.