Meynadier J, Guilhou J J
Ann Dermatol Syphiligr (Paris). 1976;103(5-6):525-45.
Numerous general metabolic systems are disturbed in association with psoriasis: the frequency of diabetes mellitus and of hyperuricaemia, lipid disturbances and a decrease in folates as a result of their excessive consumption by the skin. Cutaneous metabolism is also altered. Numerous compounds are formed in excess from glucose: amino acids, fatty acids and sterols, lactic acid--the formation of which persists in the corneal layer, ribose and ribulose--synthesised as a result of glucose-6-phosphate-dehydrogenase hyperactivity (role of the increased catabolism of dehydro-epi-androsterone) and uronic acids. The accumulation of glycogen is probably due to excessive synthesis and impaired breakdown. These abnormalities may exist to a lesser extent in healthy skin. In the corneal layer there are lipid vacuoles visible under the electron microscope. Lipogenesis is increased. The same may apply to lipolysis (blood NEFA are increased). Esterification of cholesterol is decreased. The utilisation of ATP by cell membranes is probably diminished (low ATP ase activity). The absence of formation of keratohyaline is due to persistence of the repression which normally prevents it in the mucus body. Renewal of collagen appears increased. The synthesis of DNA is increased in the lesions and neighbouring areas. It is possible that these various abnormalities are dependent upon modifications in the regulator systems of cyclic AMP and GMP, variations in which are however discussed.
糖尿病、高尿酸血症、脂质紊乱的发生率增加，以及由于皮肤过度消耗导致叶酸减少。皮肤代谢也发生改变。葡萄糖会过量生成多种化合物：氨基酸、脂肪酸、固醇、乳酸（其生成在角质层持续存在）、核糖和核酮糖（由于葡萄糖 -6-磷酸脱氢酶活性过高而合成，脱氢表雄酮分解代谢增加起作用）以及糖醛酸。糖原积累可能是由于合成过多和分解受损。这些异常在健康皮肤中可能程度较轻。在角质层，电子显微镜下可见脂质空泡。脂肪生成增加。脂解作用可能也增加（血液中非酯化脂肪酸增加）。胆固醇酯化减少。细胞膜对三磷酸腺苷（ATP）的利用可能减少（ATP 酶活性低）。透明角质颗粒缺乏形成是由于通常在黏液体中阻止其形成的抑制作用持续存在。胶原蛋白更新似乎增加。病变部位及周边区域的 DNA 合成增加。这些各种异常可能取决于环磷酸腺苷（cAMP）和环磷酸鸟苷（GMP）调节系统的改变，不过关于其变化情况仍在讨论中。
