de la Brassinne M, Failla V, Nikkels Af
Acta Clin Belg. 2013 Nov-Dec;68(6):427-32. doi: 10.2143/ACB.3387.
Psoriasis affects about 2 to 3% of the caucasian population. It is a chronic inflammatory disease affecting predominantly the skin with the involvement of autoimmune mediated mechanisms. Typical pathogenic features include an increased renewal of epidermal keratinocytes, the enlargement of the germinating compartment, papillomatosis, altered epidermal differentiation, angiogenesis, lymphangiogenesis and inflammatory infiltration. Several types of psoriasis are distinguished and may be present simultaneously in some patients. Up to 20 candidate genes have been evidenced in psoriasis. Genetic variability explains different types of the disease and influences response to therapeutics. Furthermore, psoriasis is triggered or aggravated by infections, traumatisms, medications, stress, tobacco, alcohol and endocrine factors. Severe psoriasis is frequently associated with co-morbidities as obesity, diabetes, metabolic syndrome and cardiovascular diseases. For this reason, the similar pathogenic mechanisms of psoriasis and other IMID's (Immune Mediated Inflammatory Diseases) and the use of systemic treatments shared with other specialties, an updated vision of psoriasis for the internist is mandatory.
银屑病影响约2%至3%的白种人。它是一种慢性炎症性疾病，主要累及皮肤，涉及自身免疫介导机制。典型的致病特征包括表皮角质形成细胞更新增加、生发层扩大、乳头瘤样增生、表皮分化改变、血管生成、淋巴管生成和炎症浸润。银屑病有几种类型，在一些患者中可能同时存在。在银屑病中已证实多达20个候选基因。基因变异性解释了该疾病的不同类型，并影响对治疗的反应。此外，感染、创伤、药物、压力、烟草、酒精和内分泌因素会引发或加重银屑病。重度银屑病常与肥胖、糖尿病、代谢综合征和心血管疾病等合并症相关。因此，鉴于银屑病与其他免疫介导炎症性疾病（IMID）的致病机制相似，且与其他专科共享全身治疗方法，内科医生必须对银屑病有最新的认识。
