
诊断学理论与实践››2023,Vol. 22››Issue (03): 221-229.doi:10.16150/j.1671-2870.2023.03.03
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:
基金资助:
Received:2022-06-10Online:2023-06-25Published:2023-11-17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。
中图分类号:
史玉玲, 陈文娟. 银屑病共病的现状及诊治[J]. 诊断学理论与实践, 2023, 22(03): 221-229.
SHI Yuling, CHEN Wenjuan. Psoriasis comorbidity: prevalence, diagnosis and treatment[J]. Journal of Diagnostics Concepts & Practice, 2023, 22(03): 221-229.
| [1] | 中华医学会皮肤性病学分会银屑病专业委员会. 中国银屑病诊疗指南(2018简版)[J]. 中华皮肤科杂志, 2019, 52(4):223-230. |
| Committee on Psoriasis, Chinese Society of Dermatology. Guideline for the diagnosis and treatment of psoriasis in China (2018 simplified edition)[J]. Chin J Dermatol, 2019, 52(4):223-230. | |
| [2] | NAST A, ALTENBURG A, AUGUSTIN M, et al. German S3-Guideline on the treatment of Psoriasis vulgaris, adapted from EuroGuiDerm - Part 2: Treatment monito-ring and specific clinical or comorbid situations[J]. J Dtsch Dermatol Ges, 2021, 19(7):1092-1115. |
| [3] | AUGUSTIN M, REICH K, GLAESKE G, et al. Co-morbidity and age-related prevalence of psoriasis: Analysis of health insurance data in Germany[J]. Acta Derm Venereol, 2010, 90(2):147-151. doi:10.2340/00015555-0770URL |
| [4] | ROSENØ N A L, LØRUP E H, RICHARDSON C, et al. Exploring disease comorbidities and temporal disease progression of psoriasis: an observational, retrospective, multi-database, cohort study[J]. Br J Dermatol, 2023, 188(3):372-379. doi:10.1093/bjd/ljac086URL |
| [5] | BUJA A, MIATTON A, COZZOLINO C, et al. The Prevalent Comorbidome at the Onset of Psoriasis Diagnosis[J]. Dermatol Ther (Heidelb), 2023, 13(9):2093-2105. doi:10.1007/s13555-023-00986-0 |
| [6] | FERNÁNDEZ-ARMENTEROS J M, GÓMEZ-ARBONÉS X, BUTI-SOLER M, et al. Psoriasis, metabolic syndrome and cardiovascular risk factors. A population-based study[J]. J Eur Acad Dermatol Venereol, 2019, 33(1):128-135. doi:10.1111/jdv.2019.33.issue-1URL |
| [7] | TAKESHITA J, WANG S, SHIN D B, et al. Effect of psoriasis severity on hypertension control: a population-based study in the United Kingdom[J]. JAMA Dermatol, 2015, 151(2):161-169. doi:10.1001/jamadermatol.2014.2094pmid:25322196 |
| [8] | CHIU H Y, CHANG W L, SHIU M N, et al. Psoriasis is associated with a greater risk for cardiovascular procedure and surgery in patients with hypertension: A nationwide cohort study[J]. J Dermatol. 2018; 45(12):1381-1388. doi:10.1111/jde.2018.45.issue-12URL |
| [9] | WAN M T, SHIN D B, HUBBARD R A, et al. Psoriasis and the risk of diabetes: A prospective population-based cohort study[J]. J Am Acad Dermatol, 2018, 78(2):315-322.e1. doi:S0190-9622(17)32616-6pmid:29128465 |
| [10] | SEMENOV Y R, HERBOSA C M, ROGERS A T, et al. Psoriasis and mortality in the United States: Data from the National Health and Nutrition Examination Survey[J]. J Am Acad Dermatol, 2021, 85(2):396-403. doi:10.1016/j.jaad.2019.08.011pmid:31415837 |
| [11] | ENOS C W, RAMOS V L, MCLEAN R R, et al. Comorbid obesity and history of diabetes are independently associated with poorer treatment response to biologics at 6 months: A prospective analysis in Corrona Psoriasis Re-gistry[J]. J Am Acad Dermatol, 2022, 86(1):68-76. doi:10.1016/j.jaad.2021.06.883URL |
| [12] | PINTER A, GERDES S, PAPAVASSILIS C, er al. Characterization of responder groups to secukinumab treatment in moderate to severe plaque psoriasis[J]. J Dermatolog Treat, 2020, 31(8):769-775. doi:10.1080/09546634.2019.1626973URL |
| [13] | LEBWOHL M G, LEONARDI C L, MEHTA N N, et al. Tildrakizumab efficacy, drug survival, and safety are comparable in patients with psoriasis with and without metabolic syndrome: Long-term results from 2 phase 3 randomized controlled studies (reSURFACE 1 and reSURFACE 2)[J]. J Am Acad Dermatol, 2021, 84(2):398-407. doi:10.1016/j.jaad.2020.09.047pmid:32961255 |
| [14] | ALINAGHI F, CALOV M, KRISTENSEN L E, et al. Prevalence of psoriatic arthritis in patients with psoriasis: A systematic review and meta-analysis of observational and clinical studies[J]. J Am Acad Dermatol, 2019, 80(1):251-265.e19. doi:S0190-9622(18)32149-2pmid:29928910 |
| [15] | ZHANG H, CHEN M, CUI R, et al. Prevalence of psoria-tic arthritis in Chinese population with psoriasis: A multicenter study conducted by experienced rheumatologists[J]. Chin Med J (Engl), 2023, 136(12):1439-1447. |
| [16] | Ocampo D V, Gladman D. Psoriatic arthritis[J]. F1000Res. 2019; 8:F1000 Faculty Rev-1665. |
| [17] | GRUNDY S M, STONE N J, BAILEY A L, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines published correction appears in Circulation[J]. Circulation, 2019, 139(25):e1046-e1081. |
| [18] | GELFAND J M, NEIMANN A L, SHIN D B, et al. Risk of myocardial infarction in patients with psoriasis[J]. JAMA, 2006, 296(14):1735-1741. doi:10.1001/jama.296.14.1735pmid:17032986 |
| [19] | WU H, LUO Z, LIU J, et al. Association between psoriasis and coronary artery calcification: A systematic review and meta-analysis[J]. Front Cardiovasc Med, 2022, 9:1044117. doi:10.3389/fcvm.2022.1044117URL |
| [20] | GELFAND J M, DOMMASCH E D, SHIN D B, et al. The risk of stroke in patients with psoriasis[J]. J Invest Dermatol, 2009, 129(10):2411-2418. doi:10.1038/jid.2009.112pmid:19458634 |
| [21] | AHLEHOFF O, GISLASON G H, JØRGENSEN C H, et al. Psoriasis and risk of atrial fibrillation and ischaemic stroke: a Danish Nationwide Cohort Study[J]. Eur Heart J, 2012, 33(16):2054-2064. doi:10.1093/eurheartj/ehr285pmid:21840930 |
| [22] | EDER L, JOSHI A A, DEY A K, et al. Association of Tumor Necrosis Factor Inhibitor Treatment With Reduced Indices of Subclinical Atherosclerosis in Patients With Psoriatic Disease[J]. Arthritis Rheumatol, 2018, 70(3):408-416. doi:10.1002/art.v70.3URL |
| [23] | ARMSTRONG A W, HARSKAMP C T, ARMSTRONG E J. The association between psoriasis and hypertension: a systematic review and meta-analysis of observational studies[J]. J Hypertens, 2013, 31(3):433-443. doi:10.1097/HJH.0b013e32835bcce1pmid:23249828 |
| [24] | SHAH K, MELLARS L, CHANGOLKAR A, et al. Real-world burden of comorbidities in US patients with psoriasis[J]. J Am Acad Dermatol, 2017, 77(2):287-292.e4. doi:S0190-9622(17)30426-7pmid:28623046 |
| [25] | MAMIZADEH M, TARDEH Z, AZAMI M. The association between psoriasis and diabetes mellitus: A systema-tic review and meta-analysis[J]. Diabetes Metab Syndr, 2019, 13(2):1405-1412. doi:10.1016/j.dsx.2019.01.009URL |
| [26] | ARMSTRONG A W, HARSKAMP C T, ARMSTRONG E J. The association between psoriasis and obesity: a systematic review and meta-analysis of observational studies[J]. Nutr Diabetes, 2012, 2(12):e54. doi:10.1038/nutd.2012.26 |
| [27] | GALLUZZO M, TALAMONTI M, PERINO F, et al. Bioelectrical impedance analysis to define an excess of body fat: evaluation in patients with psoriasis[J]. J Dermatolog Treat, 2017, 28(4):299-303. doi:10.1080/09546634.2016.1254326pmid:27786575 |
| [28] | RAMEZANI M, ZAVATTARO E, SADEGHI M. Evaluation of serum lipid, lipoprotein, and apolipoprotein levels in psoriatic patients: a systematic review and meta-analysis of case-control studies[J]. Postepy Dermatol Alergol, 2019, 36(6):692-702. |
| [29] | LUO L, GUO Y, CHEN L, et al. Crosstalk between cholesterol metabolism and psoriatic inflammation[J]. Front Immunol, 2023, 14:1124786. doi:10.3389/fimmu.2023.1124786URL |
| [30] | 中华医学会糖尿病学分会代谢综合征研究协作组. 中华医学会糖尿病学分会关于代谢综合征的建议[J]. 中华糖尿病杂志, 2004, 12(3):156-161. |
| Collaborative Group of Metabolic Syndrome Research, diabetes Branch. Chinese Medical Association recommendations of Diabetes Branch of Chinese Medical Association on metabolic syndrome[J] Chinese Journal of diabetes, 2004, 12(3):156-161. | |
| [31] | CHOUDHARY S, PRADHAN D, PANDEY A, et al. The Association of Metabolic Syndrome and Psoriasis: A Systematic Review and Meta-Analysis of Observational Study[J]. Endocr Metab Immune Disord Drug Targets, 2020, 20(5):703-717. doi:10.2174/1871530319666191008170409pmid:31595859 |
| [32] | BELLINATO F, GISONDI P, MANTOVANI A, et al. Risk of non-alcoholic fatty liver disease in patients with chronic plaque psoriasis: an updated systematic review and meta-analysis of observational studies[J]. J Endocrinol Investm, 2022, 45(7):1277-1288. |
| [33] | OGDIE A, GREWAL S K, NOE M H, et al. Risk of Incident Liver Disease in Patients with Psoriasis, Psoriatic Arthritis, and Rheumatoid Arthritis: A Population-Based Study[J]. J Invest Dermatol, 2018, 138(4):760-767. doi:S0022-202X(17)33097-Xpmid:29104161 |
| [34] | HEDEMANN T L, LIU X, KANG C N, et al. Associations between psoriasis and mental illness: an update for clinicians[J]. Gen Hosp Psychiatry, 2022, 75:30-37. doi:10.1016/j.genhosppsych.2022.01.006URL |
| [35] | LI C R, CHEN L, WANG L F, et al. Association between uveitis and psoriatic disease: a systematic review and Meta-analysis based on the evidence from cohort studies[J]. Int J Ophthalmol, 2020, 13(4):650-659. doi:10.18240/ijoURL |
| [36] | EPPINGA H, POORTINGA S, THIO H B, et al. Prevalence and Phenotype of Concurrent Psoriasis and Inflammatory Bowel Disease[J]. Inflamm Bowel Dis, 2017, 23(10):1783-1789. doi:10.1097/MIB.0000000000001169pmid:28617755 |
| [37] | LIU C Y, TUNG T H, LEE C Y, et al. Association of Multiple Sclerosis with Psoriasis: A Systematic Review and Meta-Analysis of Observational Studies[J]. Am J Clin Dermatol, 2019, 20(2):201-208. doi:10.1007/s40257-018-0399-9 |
| [38] | FURUE K, ITO T, TSUJI G, et al. Autoimmunity and autoimmune co-morbidities in psoriasis[J]. Immunology, 2018, 154(1):21-27. doi:10.1111/imm.12891pmid:29315555 |
| [39] | WAN J, WANG S, HAYNES K, et al. Risk of moderate to advanced kidney disease in patients with psoriasis: population based cohort study[J]. BMJ, 2013, 347:f5961. doi:10.1136/bmj.f5961URL |
| [40] | SVEDBOM A, DALÉN J, MAMOLO C, et al. Increased cause-specific mortality in patients with mild and severe psoriasis: a population-based Swedish register study[J]. Acta Derm Venereol, 2015, 95(7):809-815. |
| [41] | ZHANG X, GU H, XIE S, et al. Periodontitis in patients with psoriasis: A systematic review and meta-analysis[J]. Oral Dis, 2022, 28(1):33-43. doi:10.1111/odi.v28.1URL |
| [42] | SHALOM G, DREIHER J, COHEN A. Psoriasis and obstructive sleep apnea[J]. Int J Dermatol 2016, 55(11):e579-e584. |
| [43] | UNGPRASERT P, SRIVALI N, THONGPRAYOON C. Association between psoriasis and chronic obstructive pulmonary disease: A systematic review and meta-analysis[J]. J Dermatolog Treat, 2016, 27(4):316-321. doi:10.3109/09546634.2015.1107180pmid:26458363 |
| [44] | ACHARYA P, MATHUR M. Association between psoriasis and celiac disease: A systematic review and meta-analysis[J]. J Am Acad Dermatol, 2020, 82(6):1376-1385. doi:S0190-9622(19)33131-7pmid:31809817 |
| [45] | LAMBERT J L W, SEGAERT S, GHISLAIN P D, et al. Practical recommendations for systemic treatment in psoriasis in case of coexisting inflammatory, neurologic, infectious or malignant disorders (BETA-PSO: Belgian Evidence-based Treatment Advice in Psoriasis; part 2)[J]. J Eur Acad Dermatol Venereol, 2020, 34(9):1914-1923. doi:10.1111/jdv.v34.9URL |
| [46] | MARTINEZ-LOPEZ A, BLASCO-MORENTE G, PEREZ-LOPEZ I, et al. Studying the effect of systemic and biological drugs on intima-media thickness in patients suffering from moderate and severe psoriasis[J]. J Eur Acad Dermatol Venereol, 2018, 32(9):1492-1498. doi:10.1111/jdv.2018.32.issue-9URL |
| [47] | RIDKER P M, EVERETT B M, PRADHAN A, et al. Low-Dose Methotrexate for the Prevention of Atherosclerotic Events[J]. N Engl J Med. 2019; 380(8):752-762. doi:10.1056/NEJMoa1809798URL |
| [48] | TSAI M H, C CHAN T, LEE M S, et al. Cardiovascular Risk Associated with Methotrexate versus Retinoids in Patients with Psoriasis: A Nationwide Taiwanese Cohort Study[J]. Clin Epidemiol, 2021, 13:693-705. doi:10.2147/CLEP.S305126URL |
| [49] | AHLEHOFF O, SKOV L, GISLASON G, et al. Cardiovascular outcomes and systemic anti-inflammatory drugs in patients with severe psoriasis: 5-year follow-up of a Danish nationwide cohort[J]. J Eur Acad Dermatol Venereol, 2015, 29(6):1128-1134. doi:10.1111/jdv.12768pmid:25303139 |
| [50] | GELFAND J M, SHIN D B, ARMSTRONG A W, et al. Association of Apremilast With Vascular Inflammation and Cardiometabolic Function in Patients With Psoriasis: The VIP-A Phase 4, Open-label, Nonrandomized Clinical Trial[J]. JAMA Dermatol, 2022, 158(12):1394-1403. doi:10.1001/jamadermatol.2022.3862pmid:36129688 |
| [51] | GELFAND J M, SHIN D B, ALAVI A, et al. A Phase IV, Randomized, Double-Blind, Placebo-Controlled Crossover Study of the Effects of Ustekinumab on Vascular Inflammation in Psoriasis (the VIP-U Trial)[J]. J Invest Dermatol, 2020, 140(1):85-93.e2. doi:S0022-202X(19)32537-0pmid:31326395 |
| [52] | LEISNER M Z, LINDORFF RIIS J, GNIADECKI R, et al. Psoriasis and risk of myocardial infarction before and during an era with biological therapy: a population-based follow-up study[J]. J Eur Acad Dermatol Venereol, 2018, 32(12):2185-2190. doi:10.1111/jdv.15021pmid:29719939 |
| [53] | VON STEBUT E, REICH K, THAÇI D, et al. Impact of Secukinumab on Endothelial Dysfunction and Other Cardiovascular Disease Parameters in Psoriasis Patients over 52 Weeks[J]. J Invest Dermatol, 2019, 139(5):1054-1062. doi:S0022-202X(18)32904-Xpmid:30508547 |
| [54] | ABRAMCZYK R, QUELLER J N, RACHFAL A W, et al. Diabetes and Psoriasis: Different Sides of the Same Prism[J]. Diabetes Metab Syndr Obes, 2020, 13:3571-3577. doi:10.2147/DMSO.S273147URL |
| [55] | PINA T, ARMESTO S, LOPEZ-MEJIAS R, et al. Anti-TNF-α therapy improves insulin sensitivity in non-diabetic patients with psoriasis: a 6-month prospective study[J]. J Eur Acad Dermatol Venereol, 2015, 29(7):1325-1330. doi:10.1111/jdv.12814pmid:25353352 |
| [56] | WANG H N, HUANG Y H. Changes in metabolic parameters in psoriatic patients treated with secukinumab[J]. Ther Adv Chronic Dis, 2020, 11:2040622320944777. |
| [57] | CAI J, CUI L, WANG Y, et al. Cardiometabolic Comorbidities in Patients With Psoriasis: Focusing on Risk, Biological Therapy, and Pathogenesis[J]. Front Pharmacol, 2021, 12:774808. doi:10.3389/fphar.2021.774808URL |
| [58] | FEAGAN B G, SANDBORN W J, D'HAENS G, et al. Induction therapy with the selective interleukin-23 inhibitor risankizumab in patients with moderate-to-severe Crohn's disease: a randomised, double-blind, placebo-controlled phase 2 study[J]. Lancet, 2017, 389(10080):1699-1709. doi:S0140-6736(17)30570-6pmid:28411872 |
| [59] | VENTURINI M, ZANCA A, VENTURUZZO A, et al. Secukinumab for patients with plaque psoriasis affected by multiple sclerosis: a mini-review with a representative case report[J]. J Eur Acad Dermatol Venereol, 2020, 34(2):e110-e112. |
| [60] | BARBIERI J S, BEIDAS R S, GONDO G C, et al. Analysis of Specialist and Patient Perspectives on Strategies to Improve Cardiovascular Disease Prevention Among Persons With Psoriatic Disease[J]. JAMA Dermatol, 2022, 158(3):252-259. doi:10.1001/jamadermatol.2021.4467pmid:35044419 |
| [1] | 王泽洲, 郑莹.1990年至2020年间全球及我国肺癌的发病流行趋势及防控措施[J]. 诊断学理论与实践, 2023, 22(01): 1-7. |
| [2] | 梁晨, 于佳佳, 唐神结.世界卫生组织《全球结核病报告2022》解读[J]. 诊断学理论与实践, 2023, 22(01): 21-30. |
| [3] | 王瑾, 郭睿, 李彪, 张晓哲.18F-FDG PET/CT显像动态评估自然杀伤/T细胞淋巴瘤(鼻型)治疗预后[J]. 诊断学理论与实践, 2022, 21(06): 702-709. |
| [4] | 鲍萍萍, 吴春晓, 顾凯, 庞怡, 王春芳, 施亮, 向詠梅, 龚杨明, 窦剑明, 吴梦吟, 付晨, 施燕.上海市2016年胃癌发病特征及2002年至2016年胃癌发病趋势分析[J]. 诊断学理论与实践, 2022, 21(04): 462-469. |
| [5] | 付朝伟.阿尔茨海默病重在预防——《中国阿尔茨海默病报告2021》解读[J]. 诊断学理论与实践, 2022, 21(01): 8-11. |
| [6] | 冯国伟, 张晓娟, 郭睿, 关哲, 王越.治疗前18F-FDG PET/CT显像对结外NK/T细胞淋巴瘤的预后判断价值[J]. 诊断学理论与实践, 2021, 20(06): 533-539. |
| [7] | 王柔嘉, 常春康.调节性T细胞在骨髓增生异常综合征危险分层中的研究进展[J]. 诊断学理论与实践, 2021, 20(02): 221-224. |
| [8] | 沈小雁, 郑捷.2005年至2018年皮肤淋巴瘤WHO-EORTC分类标准的发展与比较[J]. 诊断学理论与实践, 2021, 20(01): 15-20. |
| [9] | 史玉玲.英国《皮肤科医师协会银屑病生物制剂治疗指南》(2020版)解读[J]. 诊断学理论与实践, 2021, 20(01): 37-42. |
| [10] | 黄丹, 陈崑.银屑病相关流行病学调查进展[J]. 诊断学理论与实践, 2021, 20(01): 48-52. |
| [11] | 李芹芹, 金晓龙, 袁菲.儿童系统性EB病毒阳性T细胞淋巴瘤临床病理分析一例及文献复习[J]. 诊断学理论与实践, 2020, 19(1): 63-68. |
| [12] | 王娟, 李佳.2017年至2018年上海地区男性尖锐湿疣患者人乳头瘤病毒感染的流行病学分析[J]. 诊断学理论与实践, 2020, 19(06): 572-576. |
| [13] | 沈文斌, 郭睿, 李彪.18F-FDG PET/CT代谢参数在NK/T细胞淋巴瘤预后价值的评估[J]. 诊断学理论与实践, 2019, 18(03): 349-352. |
| [14] | 刘珊珊, 牛静雅, 王天歌, 李勉, 赵志云, 徐瑜, 陆洁莉, 徐敏, 毕宇芳, 张迪.上海淞南社区2型糖尿病患者合并其他心血管代谢异常的现况流行病学调查[J]. 诊断学理论与实践, 2019, 18(03): 323-328. |
| [15] | 马媛媛, 王燕, 宋琦, 陈克敏, 赵夏, 王黎, 江旭峰, 赵维莅, 严福华.肺原发性淋巴瘤的CT影像学特点及文献复习[J]. 诊断学理论与实践, 2018, 17(05): 533-537. |
| 阅读次数 | ||||||
| 全文 |
|
|||||
| 摘要 |
|
|||||
