Tsai Shin-Yi, Chen Hsuan-Ju, Lio Chon-Fu, Ho Hui-Ping, Kuo Chien-Feng, Jia Xiaofeng, Chen Chi, Chen Yu-Tien, Chou Yi-Ting, Yang Tse-Yen, Sun Fang-Ju, Shi Leiyu
Department of Laboratory Medicine, Mackay Memorial Hospital, Taipei City, Taiwan.
Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.
PLoS One. 2017 Aug 22;12(8):e0179447. doi: 10.1371/journal.pone.0179447. eCollection 2017.
The risk of herpes zoster (HZ) between patients with psoriasis receiving and not receiving systemic therapy has received increasing attention. This study investigated the association of psoriasis with the risk of HZ.
We conducted a population-based retrospective cohort study by using the Taiwan National Health Insurance Research Database. The psoriasis cohort consisted of 4077 patients with newly diagnosed psoriasis between 2000 and 2006. Each patient with psoriasis was frequency-matched with four people without psoriasis, by sex, age and index year. (nonpsoriasis cohort; 16308 subjects). Patients who received systemic therapy were classified as having severe psoriasis, whereas those who did not receive systemic therapy were classified as having mild psoriasis. The Cox proportional hazards regression analysis was conducted to estimate the association between psoriasis and HZ risk.
The overall incidence density rate of HZ in the psoriasis cohort than in the nonpsoriasis cohort (4.50 vs. 3.44 per 1,000 person-years), with a multivariable Cox proportional hazards model measured adjusted HR of 1.29 [95% confidence interval (CI) = 1.07-1.56]. In additional, compared with the nonpsoriasis cohort, the risk of HZ was higher in the severe psoriasis cohort than in the nonpsoriasis cohort (adjusted hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.15-2.27). The comparison between psoriasis and nonpsoriasis cohorts revealed a greatest magnitude risk of HZ in women (adjusted HR, 1.36; 95% CI, 1.04-1.79), study participants in the age group of 20-39 years (adjusted HR, 1.77; 95% CI, 1.17-2.66), and study participants without any comorbidities (adjusted HR, 1.37; 95% CI, 1.02-1.84).
Our results suggest that psoriasis is associated with an increased risk of HZ, which involves differences in sex and age. Although systemic therapy may have a major role in the risk of HZ, the intrinsic factors of psoriasis cannot be excluded.
接受和未接受全身治疗的银屑病患者发生带状疱疹（HZ）的风险日益受到关注。本研究调查了银屑病与HZ风险之间的关联。
我们利用台湾国民健康保险研究数据库进行了一项基于人群的回顾性队列研究。银屑病队列由2000年至2006年间新诊断为银屑病的4077例患者组成。每例银屑病患者按性别、年龄和索引年份与4例无银屑病的人进行频数匹配（非银屑病队列；16308名受试者）。接受全身治疗的患者被归类为重度银屑病患者，而未接受全身治疗的患者被归类为轻度银屑病患者。进行Cox比例风险回归分析以估计银屑病与HZ风险之间的关联。
银屑病队列中HZ的总体发病密度率高于非银屑病队列（每1000人年分别为4.50和3.44），多变量Cox比例风险模型测得调整后的风险比（HR）为1.29[95%置信区间（CI）=1.07 - 1.56]。此外，与非银屑病队列相比，重度银屑病队列中HZ的风险高于非银屑病队列（调整后的风险比[HR]，1.61；95%置信区间[CI]，1.15 - 2.27）。银屑病队列与非银屑病队列之间的比较显示，女性（调整后的HR，1.36；95%CI，1.04 - 1.79）、20 - 39岁年龄组的研究参与者（调整后的HR，1.77；95%CI，1.17 - 2.66）以及无任何合并症的研究参与者（调整后的HR，1.37；95%CI，1.02 - 1.84）发生HZ的风险最高。
我们的结果表明，银屑病与HZ风险增加相关，这涉及性别和年龄差异。虽然全身治疗可能在HZ风险中起主要作用，但不能排除银屑病的内在因素。
