Youn Sang Woong, Kang Seo Young, Kim Sung Ae, Park Gyeong Yul, Lee Won Woo
Department of Dermatology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, South Korea.
Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, South Korea.
J Dermatol. 2015 Jun;42(6):559-66. doi: 10.1111/1346-8138.12859. Epub 2015 Mar 26.
Severe psoriasis is a systemic inflammatory disease involving major arteries and internal organs. The association between psoriasis and arterial inflammation, however, has been noted mostly in patients with moderate to severe psoriasis. Therefore, it is still not clear whether mild psoriasis also increases the arterial inflammation and cardiovascular disease. In this study, we aimed to investigate systemic inflammation using (18) F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in patients with mild psoriasis. In a nested case-control study, FDG-PET/CT findings of 10 patients with mild chronic plaque psoriasis involving a body surface area of less than 5% were compared with those of 10 age- and sex-matched healthy controls. The degree of FDG uptake in the large arteries (ascending aorta, aortic arch, descending aorta, suprarenal abdominal aorta and infrarenal abdominal aorta,) and liver were analyzed using the maximum target-to-background ratios (TBR). There were no significant demographic differences between the psoriasis patients and the control subjects (P > 0.05). Patients with psoriasis showed higher maximum TBR than healthy controls in all examined arterial segments, with statistical significance reached in the suprarenal abdominal aorta (P < 0.05), ascending thoracic aorta (P < 0.01) and infrarenal abdominal aorta (P < 0.05), and in the liver (P < 0.05). The "candy cane sign", which represents typical arterial inflammation of the thoracic aorta, was noted upon PET in the majority of psoriasis cases. In conclusion, mild psoriasis is also associated with arterial and hepatic inflammation, which can be readily demonstrated by using FDG-PET/CT.
重度银屑病是一种累及主要动脉和内脏器官的全身性炎症性疾病。然而,银屑病与动脉炎症之间的关联大多在中重度银屑病患者中被发现。因此,轻度银屑病是否也会增加动脉炎症和心血管疾病仍不清楚。在本研究中,我们旨在使用18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(FDG-PET/CT)来研究轻度银屑病患者的全身炎症。在一项巢式病例对照研究中,将10例体表面积小于5%的轻度慢性斑块状银屑病患者的FDG-PET/CT检查结果与10例年龄和性别匹配的健康对照者的结果进行比较。使用最大靶本比(TBR)分析大动脉(升主动脉、主动脉弓、降主动脉、肾上腺水平腹主动脉和肾下水平腹主动脉)和肝脏的FDG摄取程度。银屑病患者与对照受试者之间在人口统计学特征上无显著差异(P>0.05)。银屑病患者在所有检查的动脉节段中显示出比健康对照者更高的最大TBR,在肾上腺水平腹主动脉(P<0.05)、胸段升主动脉(P<0.01)和肾下水平腹主动脉(P<0.05)以及肝脏(P<0.05)中具有统计学意义。在大多数银屑病病例的PET检查中发现了代表胸主动脉典型动脉炎症的“棒棒糖征”。总之,轻度银屑病也与动脉和肝脏炎症相关,通过使用FDG-PET/CT可以很容易地证实这一点。