Nickan Research Institute Immunopathologia Persa 2423-8015 11 2 2025 07 01 The potential role of Helicobacter pylori infection in the pathogenesis and exacerbation of psoriasis, with emphasis on E-selectin levels and specific histochemical features; a cross-sectional study e43855 e43855 10.34172/ipp.2025.43855 EN Doaa Abd Elmaleek H. Pissar https://orcid.org/0009-0004-6609-6380 Sara A. Galal https://orcid.org/0000-0002-2776-628X Mahmoud Mohamad Ahmad Omira Hasan S. AL-Ghamdi https://orcid.org/0000-0002-5180-2770 Mohammad A. Alghamdi https://orcid.org/0009-0005-2850-7940 Fahad A. Alghamdi https://orcid.org/0000-0001-7279-985X Ahmed Abdulwahab Bawahab https://orcid.org/0000-0002-3657-9291 Razan Abed A. Baloush https://orcid.org/0000-0002-9275-8905 Hussain Noorwali https://orcid.org/0009-0009-6097-5292 Mohamed Nasr https://orcid.org/0000-0003-0895-846X Ebrahim M. Fayed Moustafa A.H. El-Nawasany Dina Allam Abdelmaksoud Hassan https://orcid.org/0000-0003-2677-9318 Ashraf Mohammed Said Ahmed Ali Hassan Ali Hossam Aladl Aladl Aladl Hossam M. Farid El-Zamek https://orcid.org/0000-0001-7941-6399 Hatem Mohamed Newishy Tahseen S. Mohammed https://orcid.org/0000-0002-6036-6480 Abdulkarim Hasan https://orcid.org/0000-0003-0391-306X Journal Article 10.34172/ipp.2025.43855 2025 03 26 2025 05 24 Introduction: Several studies have suggested a potential link between Helicobacter pylori infection and psoriasis; however, the underlying mechanisms remain unclear. One proposed pathway is mediated through endothelial activation and inflammatory responses, potentially indicated by changes in E-selectin expression and related histochemical features. Objectives: To assess the role of H. pylori infection in the expression of E-selectin in psoriasis patients and to evaluate related histological and immunohistochemical changes, aiming to provide insights into psoriasis pathogenesis and potential therapeutic targets. Patients and Methods: A cross-sectional study was conducted on 93 patients with psoriasis, who were evaluated using the Psoriasis Area and Severity Index (PASI), H. pylori IgG antibodies, serum E-selectin levels, histopathological examination, special staining (Masson trichrome), and Ki-67 immunostaining. Patients were categorized into H. pylori-positive (n = 35) and H. pylori-negative (n = 58) groups. Results: H. pylori-positive patients had significantly higher PASI scores (p = 0.007) and elevated E-selectin levels, particularly in severe cases (P < 0.001). Masson trichrome staining showed increased collagen in H. pylori-positive patients (64.3 ± 5%) compared to negative group (53.1 ± 2%), though not statistically significant (P = 0.152). Additionally, Ki-67 expression was significantly lower in H. pylori-positive individuals (0.51 ± 0.01%) than in H. pylori-negative ones (0.92 ± 0.01%, P = 0.04). Conclusion: H. pylori infection may contribute to the development and exacerbation of psoriasis by promoting endothelial activation and inflammation, suggesting its potential role in disease pathogenesis.