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[银屑病与银屑病关节炎在皮肤和关节方面的鉴别诊断谱]

[Differential diagnostic spectrum of psoriasis vs. psoriatic arthritis in skin and joints].

作者信息

Gerdes S, Mrowietz U, Wagner U

机构信息

Psoriasis-Zentrum an der Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, Haus 19, 24105, Kiel, Deutschland.

Sektion Rheumatologie, Department für Innere Medizin, Neurologie und Dermatologie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland.

出版信息

Z Rheumatol. 2017 Aug;76(6):484-494. doi: 10.1007/s00393-017-0340-2.

Abstract

Psoriasis and psoriatic arthritis are common disease entities in the daily routine of dermatologists and rheumatologists. The clinical management of the diseases profits tremendously from interdisciplinary contacts and shared decision-making processes. For dermatologists, recognition of early clinical symptoms of inflammatory arthropathies is pivotal. Rheumatologists, on the other hand, are required to make an early assessment of skin and nail changes in patients, since they are important parameters in the clinical classification of inflammatory joint diseases, in particular for the diagnosis of psoriatic arthritis. In patients with psoriasis, lesions on the scalp, in the anal cleft, and nail changes as well as severe generalized skin disease are all regarded as risk factors for psoriatic arthritis. The symptoms of the associated joint and spinal afflictions can vary considerably and confirmation of the diagnosis, in particular in early stages of the disease often represents a considerable challenge. The most common clinical manifestations of psoriasis and psoriatic arthritis and their differential diagnostics are discussed.

摘要

银屑病和银屑病关节炎是皮肤科医生和风湿病医生日常工作中常见的疾病实体。这些疾病的临床管理极大地受益于跨学科交流和共同决策过程。对于皮肤科医生而言,识别炎症性关节病的早期临床症状至关重要。另一方面,风湿病医生需要对患者的皮肤和指甲变化进行早期评估,因为它们是炎症性关节疾病临床分类中的重要参数,尤其是在银屑病关节炎的诊断中。在银屑病患者中,头皮、肛门裂的病变、指甲变化以及严重的全身性皮肤疾病均被视为银屑病关节炎的危险因素。相关关节和脊柱疾病的症状差异很大,确诊,尤其是在疾病早期,往往是一项相当大的挑战。本文讨论了银屑病和银屑病关节炎最常见的临床表现及其鉴别诊断。

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