Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.
Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.
J Dermatol. 2018 Mar;45(3):302-308. doi: 10.1111/1346-8138.14221. Epub 2018 Jan 21.
Both scabies and psoriasis are pruritic inflammatory skin diseases. The clinical manifestations are similar and provocation of psoriasis by mite bite was reported. The association between scabies and psoriasis was not investigated before. We conducted this nationwide population-based matched-cohort study to describe if patients with a diagnosis of scabies have a different risk of developing new psoriasis. From the National Health Insurance Research Database of Taiwan, patients with scabies (n = 5137) were identified and matched for age and sex with non-scabies controls (n = 19 142). We tracked them for a 7-year period to identify the incidence of psoriasis. One hundred and ninety (0.8%) patients with newly diagnosed psoriasis were identified; 91 (1.8%) from the scabies group and 99 (0.5%) from the control group. Patients with scabies had a higher risk of subsequent psoriasis, with a crude hazard ratio of 3.45 and an adjusted hazard ratio (aHR) of 3.03 (95% confidence interval, 2.24-4.11). An increased risk for psoriasis among patients with scabies was observed (aHR, 3.03). Immunopathology involving the T-helper 17 cell-mediated inflammatory pathway may contribute to this association. Physicians may consider implementing assessments of psoriatic symptoms in patients with scabies.
疥疮和银屑病都是瘙痒性炎症性皮肤病。临床表现相似,有报道称螨虫叮咬可引发银屑病。以前没有研究过疥疮和银屑病之间的关系。我们进行了这项全国性基于人群的匹配队列研究,以描述诊断为疥疮的患者发生新发银屑病的风险是否不同。我们从台湾全民健康保险研究数据库中确定了疥疮患者(n=5137),并按年龄和性别与非疥疮对照组(n=19142)进行匹配。我们对他们进行了 7 年的跟踪,以确定银屑病的发病率。共发现 190 例(0.8%)新发银屑病患者;疥疮组 91 例(1.8%),对照组 99 例(0.5%)。患有疥疮的患者发生后续银屑病的风险更高,粗风险比为 3.45,调整后的风险比(aHR)为 3.03(95%置信区间,2.24-4.11)。在患有疥疮的患者中观察到银屑病的风险增加(aHR,3.03)。涉及 Th17 细胞介导的炎症途径的免疫病理学可能促成这种关联。医生可能会考虑在患有疥疮的患者中评估银屑病症状。