銀屑病
疾病簡(jiǎn)介
發(fā)病原因
銀屑病病因尚不明確，證據(jù)顯示有遺傳傾向4。免疫系統(tǒng)在銀屑病發(fā)病時(shí)扮演了何種角色也是研究的熱點(diǎn)。盡管有人提出銀屑病可能是一種自體免疫性疾病，然而至今沒有明確導(dǎo)致這種疾病的自身抗原。外源和內(nèi)源誘因也可引起銀屑病，包括輕微創(chuàng)傷、曬傷、感染、系統(tǒng)用藥以及壓力5。
臨床表現(xiàn)
銀屑病發(fā)于皮膚和指甲，并伴隨一系列合并癥。皮膚損傷位于局部或全身，對(duì)稱居多，邊界清晰，紅疹和斑塊，通常覆蓋白色或銀色的鱗片。皮損引起瘙癢和刺痛。1.3%6至34.7%7的銀屑病患者患有慢性炎性關(guān)節(jié)炎（銀屑病性關(guān)節(jié)炎），導(dǎo)致關(guān)節(jié)變形和殘疾。4.2%至69%的銀屑病病人有指甲病變8,9,10。報(bào)告稱銀屑病患者更易患心血管疾病和其他非傳染性疾?。∟CDs）5,11,12。
疾病治療
銀屑病的治療仍基于控制癥狀。可用局部和全身治療以及光線療法。臨床常結(jié)合使用以上治療方法?；颊咄ǔＰ杞K身治療緩解疾病。至今為止，還未有完全治愈銀屑病的方法。此外，銀屑病患者的護(hù)理不僅包括治療皮損及關(guān)節(jié)損傷，還包括辨別和處理已經(jīng)出現(xiàn)或可能出現(xiàn)的常見合并癥，例如心血管和代謝疾病以及心理疾病。
1. Institute for Health Metrics and Evaluation (IHME). Global Burden of Disease Study 2010: Results by Cause 1990–2010. Seattle: IHME; 2012.
2. Gibbs S. Skin disease and socioeconomic conditions in rural Africa: Tanzania. Int J Dermatol. 1996;35(9):633–9.
3. Danielsen K, Olsen AO, Wilsgaard T, Furberg AS. Is the prevalence of psoriasis increasing? A 30–year follow-up of a population–based cohort. Br J Dermatol. 2013;168:1303–10.
4. Harden JL, Krueger JG, Bowcock AM. The immunogenetics of psoriasis: a comprehensive review. J Autoimmun. 2015;64:66–73.
5. Boehncke W-H, Schon MP. Psoriasis. Lancet. 2015;386(9997):983–94.
6. Bedi TR. Clinical profile of psoriasis in North India. Indian J Dermatol Venereol Leprol. 1995;61(4):202–5.
7. Pariser D, Schenkel B, Carter C, Farahi K, Brown TM, Ellis CN, and Psoriasis Patient Interview Study Group. A multicenter, non-interventional study to evaluate patient-reported experiences of living with psoriasis. J Dermatol Treat. 2015;1–8.
8. Alshami MA. Clinical profile of psoriasis in Yemen, a 4-year retrospective study of 241 patients. J Eur Acad Dermatol Venereol. 2010;24(Suppl. 4):14.
9. Falodun OA. Characteristics of patients with psoriasis seen at the dermatology clinic of a tertiary hospital in Nigeria: a 4-year review 2008–2012. J Eur Acad Dermatol Venereol. 2013;27(Suppl. 4).
10. Reich K, Kruger K, Mossner R, Augustin M. Epidemiology and clinical pattern of psoriatic arthritis in Germany: a prospective interdisciplinary epidemiological study of 1511 patients with plaque-type psoriasis. Br J Dermatol. 2009;160(5):1040–7.
11. Augustin M, Radtke MA, Glaeske G, Reich K, Christophers E, Schaefer I et al. Epidemiology and Comorbidity in Children with Psoriasis and Atopic Eczema. Dermatology. 2015;231(1):35–40.
12. Vena GA, Altomare G, Ayala F, Berardesca E, Calzavara-Pinton P, Chimenti S et al. Incidence of psoriasis and association with comorbidities in Italy: a 5-year observational study from a national primary care database. Eur J Dermatol. 2010;20(5):593–8.