Prussick Ronald, Wu Jashin J, Armstrong April W, Siegel Michael P, Van Voorhees Abby S
a Department of Dermatology , George Washington University , Washington D.C. , USA.
b Department of Dermatology , Kaiser Permanente Los Angeles Medical Center , Los Angeles , CA , USA.
J Dermatolog Treat. 2018 Jun;29(4):329-333. doi: 10.1080/09546634.2017.1373737. Epub 2017 Oct 24.
Treatment of solid organ transplant patients who have psoriasis can be a therapeutic challenge. Biologic and systemic drugs used to treat psoriasis can result in an increase in infections or malignancies.
We sought to develop a treatment algorithm for organ transplant recipients (OTR) diagnosed with psoriasis vulgaris.
A systematic literature search for psoriasis treatment in organ transplant patients was performed using MEDLINE and GOOGLE.
In mild-to-moderate disease, topical therapy should be a first-line treatment. In moderate-to-severe disease, first-line treatment is acitretin with narrow band ultraviolet light (NBUVB), NBUVB, or acitretin. Second-line treatment is increasing the current antirejection drug dose. Other systemic or biologic therapies should be reserved for more severe or refractory cases.
No systematic clinical studies have been done to explore psoriasis treatments among affected solid organ transplant patients who have psoriasis, and only a few case reports are available. The algorithm for best practices was developed based on these reports and on the clinical experience and judgment of the Medical Board of the National Psoriasis Foundation. There remains a need for further research on the management of psoriasis in the organ transplant patient population.
治疗患有银屑病的实体器官移植患者可能是一项治疗挑战。用于治疗银屑病的生物制剂和全身性药物可能会导致感染或恶性肿瘤增加。
我们试图为诊断为寻常型银屑病的器官移植受者（OTR）制定一种治疗方案。
使用MEDLINE和谷歌对器官移植患者的银屑病治疗进行系统的文献检索。
对于轻度至中度疾病，局部治疗应作为一线治疗。对于中度至重度疾病，一线治疗是阿维A联合窄谱中波紫外线（NBUVB）、NBUVB或阿维A。二线治疗是增加当前抗排斥药物剂量。其他全身性或生物治疗应保留用于更严重或难治性病例。
尚未进行系统的临床研究来探索患有银屑病的实体器官移植患者的银屑病治疗方法，仅有少数病例报告。基于这些报告以及美国国家银屑病基金会医学委员会的临床经验和判断制定了最佳实践方案。对于器官移植患者群体中银屑病的管理仍需要进一步研究。
