Department of Radiology, China Medical University Hospital, No. 2 Yuh-Der Road, Taichung, 404, Taiwan; Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University Hospital, No. 2 Yuh-Der Road, Taichung, 404, Taiwan.
Br J Dermatol. 2014 Apr;170(4):890-4. doi: 10.1111/bjd.12811.
The cingulate cortex is the main area in the brain involved in pruritus processing and is deactivated after scratching. Lichen simplex chronicus (LSC) is a common pruritic skin disorder characterized by skin lichenification following excessive scratching. Psychological factors may contribute to both the development and persistence of LSC.
To estimate the hazard ratio (HR) of LSC in people with anxiety disorders compared with the general population.
In this nationwide population-based retrospective cohort study we identified a total of 69 386 people, who formed the anxiety cohort, by using the Taiwan National Health Insurance Research Database from 2000 to 2009. The comparison cohort was composed of randomly selected people frequency matched for age (within 5-year intervals), sex and index date (the date of anxiety diagnosis) based on a 1 : 2 ratio. The risk of LSC was estimated as HRs and 95% confidence intervals (CIs) using the Cox proportional hazards model.
After adjusting for age, sex and LSC-associated comorbidities, the people with anxiety had a 1·41-fold greater risk of developing LSC compared with the people in the comparison cohort (HR 1·41, 95% CI 1·30-1·52, P < 0·0001). In particular, individuals with obsessive-compulsive disorder had a significantly increased risk of developing LSC (HR 1·72, 95% CI 1·03-2·88, P = 0·0395).
This study demonstrates that having an anxiety disorder is associated with an increased risk of LSC. Psychological factors were found to contribute to LSC. We recommend combining the management of LSC and psychological disorders to achieve favourable outcomes.
扣带回皮层是大脑中参与瘙痒处理的主要区域，搔抓后会失活。慢性单纯性苔藓（lichen simplex chronicus，LSC）是一种常见的瘙痒性皮肤病，其特征是过度搔抓后皮肤出现苔藓样变。心理因素可能与 LSC 的发生和持续存在有关。
估计焦虑障碍患者发生 LSC 的风险比（hazard ratio，HR）与普通人群相比。
在这项基于全国人群的回顾性队列研究中，我们使用台湾全民健康保险研究数据库，于 2000 年至 2009 年共确定了 69386 名患者，构成了焦虑队列。对照组由根据年龄（5 年间隔内）、性别和指数日期（焦虑诊断日期），按 1：2 比例随机选择的人群组成。使用 Cox 比例风险模型，以 HR 和 95%置信区间（CI）来估计 LSC 的风险。
在调整了年龄、性别和 LSC 相关合并症后，与对照组相比，患有焦虑症的患者发生 LSC 的风险增加了 1.41 倍（HR 1.41，95%CI 1.30-1.52，P<0.0001）。特别是强迫症患者发生 LSC 的风险显著增加（HR 1.72，95%CI 1.03-2.88，P=0.0395）。
本研究表明，患有焦虑症与发生 LSC 的风险增加相关。心理因素被发现与 LSC 有关。我们建议将 LSC 和心理障碍的管理相结合，以获得良好的治疗效果。
