Psoriasis and risk of the COVID-19: is there a role for angiotensin converting enzyme (ACE)?

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) first appeared in Wuhan, China in December 2019 resulting in the COVID-19 pandemic. It has been shown that SARS-CoV-2 spike protein shares a high similarity with SARS-CoV spike protein with a strong binding affinity to human Angiotensin Converting Enzyme 2 (ACE2) receptor. Skin tissue may be a possible specific target for the SARS-CoV-2. Preliminary reports from the COVID-19 infection have shown cutaneous manifestation, including erythematous rash, widespread urticaria, and chickenpox-like vesicles. Moreover, many studies have shown the role of ACE in the development, severity, and complications of psoriasis. Herein, we discuss a possible shared mechanism of psoriasis with SARS-CoV-2; also, we propose a therapeutic approach to balance the effect of ACE activity in these patients.