Christophers Enno
Department of Dermatology, Schleswig-Holstein University Clinic, 24105 Kiel, Germany.
Clin Dermatol. 2007 Nov-Dec;25(6):529-34. doi: 10.1016/j.clindermatol.2007.08.006.
Epidemiological studies have shown that, in psoriasis patients, associated disorders may occur more frequently than expected. Such comorbidities include psoriatic arthritis, psoriatic pustular diseases, Crohn disease, and signs of metabolic syndrome, which leads to atherosclerosis with coronary heart disease. Although the disorders represent separate entities, they appear to follow overlapping pathogenic pathways. Comorbidities often become clinically manifest years after onset of psoriasis and are frequently seen in severe disease. Persistent low-grade inflammation with secretion of proinflammatory cytokines (eg, tumor necrosis factor alpha) favors the development of insulin resistance and metabolic syndrome. In addition, biochemical and immunologic observations point toward an inflammatory immune mechanism that uses tools of the innate defense armamentarium.
流行病学研究表明，银屑病患者并发相关疾病的频率可能高于预期。这些合并症包括银屑病关节炎、脓疱型银屑病、克罗恩病以及代谢综合征的体征，后者会导致动脉粥样硬化及冠心病。尽管这些疾病是独立的实体，但它们似乎遵循重叠的致病途径。合并症通常在银屑病发病数年之后才会在临床上显现，并且在重症患者中很常见。促炎细胞因子（如肿瘤坏死因子α）持续低水平分泌引发的炎症有利于胰岛素抵抗和代谢综合征的发展。此外，生化和免疫学观察结果指向一种利用先天性防御机制工具的炎性免疫机制。
