Ataş Hatice, Gönül Müzeyyen
Department of Dermatology, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
Postepy Dermatol Alergol. 2017 Jun;34(3):268-272. doi: 10.5114/pdia.2016.61630. Epub 2017 May 29.
Palmoplantar pustulosis (PPP) is a chronic pustular inflammatory skin disease; however, its pathogenesis is not well understood. Several factors, such as genetics, tobacco use and autoimmune issues, may contribute to this disease.
This research was conducted to investigate the relationships between insulin resistance, thyroid disease and PPP.
Thirty-three patients with PPP and 27 age- and gender-matched controls were analysed for their smoking histories, thyroid function tests, anti-thyroid peroxidase antibody (anti-TPO) levels, fasting glucose, fasting insulin levels and the homeostatic model assessment (HOMA) index for insulin resistance.
We found significant differences between the PPP and control groups according to their tobacco use and anti-TPO levels ( = 0.009 and = 0.009, respectively). The proportion of tobacco use was 90% in the PPP patients and 63% in the controls. Gender and tobacco use were predictive risk factors for PPP in the multivariate analysis ( = 141.7, < 0.0001 and = 147.6, = 0.006, respectively). An anti-TPO level > 35 U/ml and the presence of a thyroid abnormality were independent risk factors in the univariate, but not the multivariate analysis ( = 4.2, = 0.025 and = 5.4, = 0.004, respectively). A moderate correlation between the gender and anti-TPO level was found ( = 0.361, = 0.039); however, the fasting glucose, insulin and HOMA index were not significant between the PPP and control groups.
Female gender and smoking were the most important risk factors for PPP; however, the increase in the anti-TPO level may be related to the predominance of females afflicted with this disease. Additional studies are necessary to clarify the relationships between PPP, thyroid disease and diabetes mellitus.
掌跖脓疱病（PPP）是一种慢性脓疱性炎症性皮肤病；然而，其发病机制尚未完全明确。多种因素，如遗传、吸烟和自身免疫问题，可能与该病有关。
本研究旨在探讨胰岛素抵抗、甲状腺疾病与掌跖脓疱病之间的关系。
对33例掌跖脓疱病患者和27例年龄及性别匹配的对照组进行吸烟史、甲状腺功能检查、抗甲状腺过氧化物酶抗体（抗-TPO）水平、空腹血糖、空腹胰岛素水平及胰岛素抵抗的稳态模型评估（HOMA）指数分析。
根据吸烟情况和抗-TPO水平，我们发现掌跖脓疱病患者组与对照组之间存在显著差异（分别为P = 0.009和P = 0.009）。掌跖脓疱病患者的吸烟比例为90%，对照组为63%。在多因素分析中，性别和吸烟是掌跖脓疱病的预测危险因素（分别为P = 141.7，P < 0.0001和P = 147.6，P = 0.006）。抗-TPO水平> 35 U/ml和甲状腺异常在单因素分析中是独立危险因素，但在多因素分析中不是（分别为P = 4.2，P = 0.025和P = 5.4，P = 0.004）。发现性别与抗-TPO水平之间存在中度相关性（r = 0.361，P = 0.039）；然而，掌跖脓疱病患者组与对照组之间的空腹血糖、胰岛素和HOMA指数无显著差异。
女性性别和吸烟是掌跖脓疱病最重要的危险因素；然而，抗-TPO水平的升高可能与患该病女性占主导地位有关。需要进一步研究以阐明掌跖脓疱病、甲状腺疾病和糖尿病之间的关系。
