Albaghdadi Abdullah
Department of Pharmacology, Faculty of Medicine, University of Jeddah, Jeddah. Saudi Arabia.
Endocr Metab Immune Disord Drug Targets. 2017;17(3):189-199. doi: 10.2174/1871530317666170804153751.
Psoriasis is a chronic and complex autoimmune inflammatory skin disease that affects over 125 million people worldwide. It can exhibit at any age, in spite of the fact that children are less normally influenced than adults. It is characterized by distinct erythematous plaques shielded with conspicuous silvery scales that shows up in different areas of the skin. Knowledge of pathophysiology, especially the pathogenesis of psoriasis, has significantly progressed in the recent decade. Advancement in molecular knowledge leads to better understanding of the disease, thus influencing the development of efficient treatment modalities. However, even with the availability of various options of treatment most of the efficient treatment modalities are costly. Expenses of health care bring about major financial weight to the patients as well as to health care systems. Thus, it was important to review the available current treatment options and those which are under development, in terms of efficacy, safety and cost to assist in selecting the most appropriate treatment for psoriasis patients.
Literatures were searched by using key words psoriasis, topical treatment, systemic treatment, biologics and phototherapies, on Embase, Medline, Jstor, Cochrane and Merck Index databases.
Life-style choices such as smoking, alcohol consumption, obesity and stress are recognised as risk factors and triggers associated with psoriasis. Psoriasis poses psycho-social and economic burden on affected patients that sometimes leads to depression, reduced social interaction and suicidal tendencies in patients. Depending on the type, severity and extent of the disease, comorbidities, patient preference, efficacy and safety profile, numerous treatment modalities and therapeutic agents are available such as topical, systemic, biologic and phototherapeutic treatments. However, it was found that among all the current available treatments for psoriasis, biologic agents and phototherapeutic modalities are the most commonly employed treatment modalities for moderate to severe psoriasis.
Evaluation of present-day available treatment alternatives will surely help physician to select a suitable module for each patient while keeping in mind the financial status of the patient. Future research should aim to develop therapies which are efficient, safe and cost-effective.
银屑病是一种慢性、复杂的自身免疫性炎症性皮肤病，全球有超过1.25亿人受其影响。尽管儿童受影响的情况比成人少见，但该病可在任何年龄出现。其特征为皮肤不同部位出现明显的红斑鳞屑斑块，上面覆盖着显眼的银白色鳞屑。近十年来，对银屑病病理生理学的认识，尤其是发病机制方面，已有显著进展。分子知识的进步使人们对该疾病有了更好的理解，进而影响了有效治疗方式的发展。然而，即便有多种治疗选择，大多数有效的治疗方式费用都很高。医疗费用给患者以及医疗系统都带来了巨大的经济负担。因此，有必要从疗效、安全性和成本方面对现有的以及正在研发的治疗选择进行综述，以帮助为银屑病患者选择最合适的治疗方法。
通过在Embase、Medline、Jstor、Cochrane和默克索引数据库中使用关键词银屑病、局部治疗、全身治疗、生物制剂和光疗法来检索文献。
吸烟、饮酒、肥胖和压力等生活方式选择被认为是与银屑病相关的风险因素和触发因素。银屑病给患者带来心理社会和经济负担，有时会导致患者抑郁、社交互动减少和有自杀倾向。根据疾病的类型、严重程度和范围、合并症、患者偏好、疗效和安全性概况，有多种治疗方式和治疗药物可供选择，如局部治疗、全身治疗、生物治疗和光疗。然而，研究发现，在目前所有治疗银屑病的方法中，生物制剂和光疗方式是治疗中度至重度银屑病最常用的治疗方式。
对当前可用治疗方案的评估肯定有助于医生为每位患者选择合适的方案，同时考虑患者的经济状况。未来的研究应致力于开发高效、安全且具有成本效益的疗法。
