de Rie M A, van Kuijk A W R, Goedkoop A Y, Tak P P
Academisch Medisch Centrum/Universiteit van Amsterdam, Afd. Huidziekten, Amsterdam.
Ned Tijdschr Geneeskd. 2007 Aug 4;151(31):1716-22.
The symptoms ofpsoriatic arthritis vary from arthralgia and enthesitis to chronic erosive and mutilating arthritis, and are seen in 6-39% of all psoriasis patients. Because of increasing awareness of the clinical signs of psoriatic arthritis among both dermatologists and rheumatologists, the diagnosis ofpsoriatic arthritis is made more often; this is important since earlier diagnosis and treatment can avoid irreversible joint destruction. The overlap between the immunological mechanisms in the pathogenesis ofpsoriasis and psoriatic arthritis has led to the identification of common therapeutic targets, of which tumour-necrosis factor (TNF) is the most important. The successful treatment of psoriasis patients with TNF-a-blocking agents has not only brought about a marked improvement in the quality of life of many patients but has also improved the insight into the pathogenesis, for example by demonstrating that the role of acquired immunity is much more important than was previously thought. The Dutch Society of Dermatology and Venereology and the Dutch Society of Rheumatology have drawn up guidelines for the treatment of patients with psoriasis and psoriatic arthritis using these so-called biologics.
银屑病关节炎的症状从关节痛和附着点炎到慢性侵蚀性和致残性关节炎不等，在所有银屑病患者中的发生率为6%至39%。由于皮肤科医生和风湿病学家对银屑病关节炎临床体征的认识不断提高，银屑病关节炎的诊断更为常见；这很重要，因为早期诊断和治疗可避免不可逆转的关节破坏。银屑病和银屑病关节炎发病机制中的免疫机制重叠导致了共同治疗靶点的确定，其中肿瘤坏死因子（TNF）最为重要。用TNF-α阻断剂成功治疗银屑病患者不仅显著改善了许多患者的生活质量，还增进了对发病机制的认识，例如通过证明获得性免疫的作用比以前认为的更为重要。荷兰皮肤病与性病学会和荷兰风湿病学会已经制定了使用这些所谓生物制剂治疗银屑病和银屑病关节炎患者的指南。
