Smith Jaclyn, Cline Abigail, Feldman Steven R
From the Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
South Med J. 2017 Jan;110(1):65-75. doi: 10.14423/SMJ.0000000000000596.
Psoriasis treatments range from topical treatments and phototherapy to oral systemic medications and injections. Despite good control of the disease when applying appropriate treatments (according to disease severity, insurance parameters, patient preference, and patients' ability to adhere), continued advancements will allow even better symptomatic control, reduced adverse effects, and patient satisfaction. This review aims to assess traditional and new psoriasis treatments and how to apply them in clinical practice. A literature review on psoriasis treatments and clinical applications was performed using PubMed. Mild-to-moderate psoriasis treatments include topicals, localized phototherapy, and newer therapies combining two types of topicals, phototherapy with topicals, and easy-to-use foam and spray vehicles. Moderate-to-severe psoriasis therapies include monotherapy or various combinations of generalized phototherapy, oral treatments, and biologic agents, with new oral and biologic agents on the horizon. Dermatologists and primary care providers share roles in screening for associated comorbidities (including cardiovascular disorders, chronic kidney disease, Crohn disease, dyslipidemia, diabetes mellitus/insulin resistance, depression, metabolic syndrome, obesity, and psoriatic arthritis), managing patients' treatments, and reevaluating treatment needs as new therapies are approved. Continued advancements in psoriasis treatment and improvement in coordinated care will allow better overall care of patients with psoriasis.
银屑病的治疗方法多种多样，从局部治疗、光疗到口服全身性药物及注射治疗。尽管在应用适当治疗方法时（根据疾病严重程度、保险参数、患者偏好以及患者的依从能力）疾病能得到良好控制，但持续的进展将带来更好的症状控制、更少的不良反应以及更高的患者满意度。本综述旨在评估传统和新型银屑病治疗方法以及如何在临床实践中应用它们。使用PubMed对银屑病治疗方法及临床应用进行了文献综述。轻度至中度银屑病的治疗方法包括局部用药、局部光疗以及将两种局部用药相结合、光疗与局部用药相结合以及易于使用的泡沫和喷雾剂型的新型疗法。中度至重度银屑病的治疗方法包括全身光疗、口服治疗和生物制剂的单一疗法或各种联合疗法，并且有新型口服和生物制剂即将出现。皮肤科医生和初级保健提供者在筛查相关合并症（包括心血管疾病、慢性肾病、克罗恩病、血脂异常、糖尿病/胰岛素抵抗、抑郁症、代谢综合征、肥胖症和银屑病关节炎）、管理患者治疗以及随着新疗法获批重新评估治疗需求方面发挥着共同作用。银屑病治疗的持续进展以及协调护理的改善将使银屑病患者得到更好的整体护理。
