诊断学理论与实践

诊断学理论与实践 ›› 2023, Vol. 22 ›› Issue (03): 221-229.doi: 10.16150/j.1671-2870.2023.03.03

• 专家论坛 • 上一篇    下一篇

银屑病共病的现状及诊治

史玉玲(), 陈文娟   

  1. 上海市皮肤病医院/同济大学附属皮肤病医院，同济大学医学院银屑病研究所，上海 200443
  • 收稿日期:2022-06-10 出版日期:2023-06-25 发布日期:2023-11-17
  • 通讯作者: 史玉玲 E-mail：shiyuling1973@tongji.edu.cn
  • 基金资助:
    国家自然科学基金(82073429);国家自然科学基金(82273510);国家自然科学基金(82103707);上海市教委科研创新计划(2019-01-07-0-007-E00046);上海市优秀学术带头人计划(20XD1403300);上海申康中心第二轮三年行动计划重大临床研究项目(SHDC2020CR1014B)

Psoriasis comorbidity: prevalence, diagnosis and treatment

SHI Yuling(), CHEN Wenjuan   

  1. Shanghai Skin Disease Hospital, Shanghai 200443, China
  • Received:2022-06-10 Online:2023-06-25 Published:2023-11-17

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摘要：

全球银屑病发病率为1%~3%，我国银屑病发病率约为0.47%。57.9%的银屑病患者至少合并1种银屑病共病，共病不仅影响患者的银屑病进程及严重程度，同时影响患者的治疗选择和效果。银屑病共病中，银屑病关节炎最常见，全球银屑病患者的银屑病关节炎患病率介于6%~42%，其中亚洲人群约为14%，中国人群约为4.9%。银屑病是心脏疾病的危险因素之一，是心肌梗死的独立危险因素。相较于非银屑病患者，银屑病患者的代谢性疾病患病率明显升高，银屑病患者的患糖尿病的风险增加0.69倍；轻度银屑病患者患肥胖的风险增加0.46倍，而中重度银屑病患者患肥胖的风险增加1.23倍。此外，银屑病患者的抑郁症患病率增加0.5倍，自身免疫性疾病等患病风险增加更高。在银屑病并共病治疗中，系统抗炎治疗不仅可以减轻或消退患者的皮肤炎症，同时可缓解银屑病共病的发生发展或严重程度。银屑病共病治疗原则需考虑患者银屑病的病情，同时决于共病病种、共病恶化风险等。多学科联合是诊治银屑病及银屑病共病的趋势，皮肤科医生与专科医生的跨学科合作十分重要。

关键词: 银屑病, 共病, T细胞, 流行病学

Abstract:

The global incidence of psoriasis is about 1%-3%, and in China is about 0.47%. It is reported that 57.9% of psoriasis patients have at least one psoriasis comorbidity, which not only affects the progression and severity of psoriasis, but also affects the treatment choice and therapeutic effect for patients. Psoriatic arthritis is the most common comorbidity, with the prevalence of 6% to 42% in the world, of approximately 14% in Asia，and of about 4.9% in Chinese population. Psoriasis is one of the risk factors for cardiovascular disease and is an independent risk factor for myocardial infarction. Compared with non-psoriasis patients, psoriasis patients have an higher prevalence of metabolic diseases.The risk of diabetes in psoriasis patients increases by 0.69 times.The risk of obesity increases by 0.46 times in mild psoriasis patients and by 1.23 times in moderate to severe psoriasis patients. In addition, the prevalence of depression in psoriasis patients increases by 0.5 times, and the risk of autoimmune diseases is also higher. For treatment of psoriasis and psoriasis comorbidities, systemic anti-inflammatory treatment can not only relieve or eliminate skin inflammation, but also alleviate the occurrence, progression or severity of psoriasis comorbidities. The treatment principle of psoriasis comorbidities should take the condition of the patient’s psoriasis into consideration, and should also depend on the type of comorbidity, the risk of worsening of comorbidity, etc. Multidisciplinary collaboration is the trend in the diagnosis and treatment of psoriasis and its comorbidities. The cross-disciplinary cooperation between dermatologists and specialists matters a lot.

Key words: Psoriasis, Comorbidity, T cell, Epidemiology

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