Boehncke Wolf-Henning, Boehncke Sandra
Center for Dermatology and Venerology, Johann Wolfgang Goethe University Clinic, Frankfurt am Main, Germany.
J Dtsch Dermatol Ges. 2008 Aug;6(8):622-5. doi: 10.1111/j.1610-0387.2008.06785.x. Epub 2008 Jun 16.
Psoriasis is a common, chronic inflammatory and frequently severe skin disease. Recent epidemiologic studies have documented an increased cardio-vascular mortality in psoriasis patients. Our own work focuses on endothelial cells as mediators for the development of inflammatory infiltrates and more recently as a victim of injury caused by infiltrating cells. In this context, we have measured systemic effects of this seemingly cutaneous inflammation, which results in a metabolic state much like that in patients developing diabetes mellitus and insulin resistance. The latter is an important pathomechanism causing endothelial cell dysfunction and subsequently cardiovascular diseases such as myocardial infarction or stroke. Co-morbidities observed in psoriatic patients therefore represent complications of the accompanying systemic inflammation and are likely to be mediated through the mechanism of insulin resistance. As psoriasis is a risk factor for cardiovascular diseases, its adequate management must include the treatment of other known risk factors. Dermatologists should discuss the elevated cardiovascular risk with their psoriasis patients and encourage them not to smoke and to normalize their body weight.
银屑病是一种常见的慢性炎症性皮肤病，病情常较为严重。最近的流行病学研究表明，银屑病患者的心血管死亡率有所上升。我们自己的研究工作聚焦于内皮细胞，它是炎症浸润发展的介质，最近又被视为浸润细胞所造成损伤的受害者。在此背景下，我们测量了这种看似仅累及皮肤的炎症所产生的全身影响，这种炎症会导致一种代谢状态，很类似于糖尿病和胰岛素抵抗患者的代谢状态。后者是导致内皮细胞功能障碍以及随后引发心血管疾病（如心肌梗死或中风）的重要病理机制。因此，银屑病患者中观察到的合并症是伴随的全身炎症的并发症，很可能是通过胰岛素抵抗机制介导的。由于银屑病是心血管疾病的一个危险因素，对其进行充分管理必须包括对其他已知危险因素的治疗。皮肤科医生应与银屑病患者讨论其升高的心血管风险，并鼓励他们戒烟并使体重正常化。
