Pearce Daniel J, Morrison Allison E, Higgins Kristen B, Crane Martin M, Balkrishnan Rajesh, Fleischer Alan B, Feldman Steven R
Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1071, USA.
J Dermatolog Treat. 2005;16(5-6):319-23. doi: 10.1080/09546630500335977.
Psoriasis treatment is frequently complicated by the various types and severities of disease as well as the large number of therapies available. Another critical consideration in treatment planning is the presence of comorbid diseases.
The purpose of this study was to evaluate the relative prevalence of major comorbid disease states in patients with psoriasis and to identify significant predictors of these concurrent diseases in such patients.
A retrospective chart review of 753 patients from an academic dermatology practice was performed. The patients were identified by ICD-9 code for psoriasis in billing records of patients seen between 1997 and 2000. Data on comorbidities were compiled from review of electronic chart notes from all physician visits in the university practice.
Comorbid diagnoses were listed in 551 out of 753 (73%) charts. As would be expected, hypertension, dyslipidaemia, diabetes and heart disease were the most common comorbidities; renal failure and hepatitis were least likely. Hepatitis was associated with use of systemic therapies (odds ratio = 2.19) and non-white race. When compared with national prevalence estimates, psoriasis patients had increased heart disease, hypertension, diabetes and emphysema; however, these findings must be interpreted with some caution.
Comorbid diseases are common in psoriasis patients and should be taken into account during treatment planning and surveillance; they may pose unique challenges in caring for patients with psoriasis, particularly those requiring systemic therapy.
银屑病的治疗常因疾病的各种类型和严重程度以及大量可用治疗方法而变得复杂。治疗规划中的另一个关键考虑因素是合并症的存在。
本研究的目的是评估银屑病患者主要合并疾病状态的相对患病率，并确定这些患者中这些并发疾病的重要预测因素。
对一家学术皮肤科诊所的753例患者进行回顾性病历审查。通过1997年至2000年间就诊患者计费记录中的银屑病ICD-9编码来识别这些患者。合并症数据来自对大学诊所所有医生就诊的电子病历记录的审查。
753份病历中有551份（73%）列出了合并症诊断。正如预期的那样，高血压、血脂异常、糖尿病和心脏病是最常见的合并症；肾衰竭和肝炎的可能性最小。肝炎与全身治疗的使用（比值比=2.19）和非白种人有关。与全国患病率估计值相比，银屑病患者的心脏病、高血压、糖尿病和肺气肿患病率有所增加；然而，这些发现必须谨慎解释。
合并症在银屑病患者中很常见，在治疗规划和监测过程中应予以考虑；它们可能给银屑病患者的护理带来独特挑战，尤其是那些需要全身治疗的患者。
