Severe Hypocalcemia as an Unexpected Trigger for Psoriasis Exacerbation in Chronic Hypoparathyroidism: A Case Report

Hypoparathyroidism-induced hypocalcemia represents a rare cause for psoriasis exacerbation through various mechanisms including disruption of calcium-dependent keratinocyte differentiation and proliferation pathways. Epidermal barrier function and normal keratinization processes are normally maintained by normal calcium levels, where its deficiency can end in abnormal inflammatory processes and impaired skin homeostasis. We present a 52-year-old Egyptian male with chronic post-surgical hypoparathyroidism who developed severe psoriatic plaques during periods of profound hypocalcemia (7.2 mg/dL). Marked improvement of skin lesions as well as normalization of calcium levels were achieved through psoriasis therapy along with aggressive calcium, demonstrating the therapeutic importance of addressing underlying metabolic abnormalities in dermatological conditions, especially psoriasis.