Skorvanek Matej, Bhatia Kailash P
Department of Neurology P. J. Safarik University Kosice Slovakia.
Department of Neurology University Hospital L. Pasteur Kosice Slovakia.
Mov Disord Clin Pract. 2016 Sep 8;4(1):21-31. doi: 10.1002/mdc3.12425. eCollection 2017 Jan-Feb.
Parkinson's disease (PD) and the skin are related in a number of ways, including clinical abnormalities of the disease itself and skin-related side effects of dopaminergic medication, pumps, and surgical therapies. Recent advances in understanding the role of α-synuclein suggest skin biopsies as a potential diagnostic or even a premotor marker of PD.
The PubMed database was searched for publications up to October 2015, and the current evidence on skin-related issues in PD was comprehensively summarized.
The evidence was summarized on the prevalence, etiology, and management of seborrheic dermatitis, sweating dysfunctions, bullous pemphigoid, and malignant melanoma, as well as therapy-related skin disorders, especially those observed in amantadine, rotigotine, apomorphine, and levodopa/carbidopa intestinal gel therapies and deep-brain stimulation. Skin biopsies evaluating the presence of α-synuclein, the density and morphology of cutaneous nerves, and skin fibroblast functions also are discussed.
Skin disorders are a common manifestation of PD. However, the exact pathophysiology and prevalence of these disorders are not well understood, and more systematic research is needed in this regard. Peripheral tissue biopsies as a diagnostic marker of PD are an exciting avenue in future PD research, although multiple caveats and pending issues need to be solved before they can be used in routine clinical practice.
帕金森病（PD）与皮肤在多个方面存在关联，包括疾病本身的临床异常以及多巴胺能药物、泵和手术治疗的皮肤相关副作用。在理解α-突触核蛋白作用方面的最新进展表明，皮肤活检可能是PD的一种潜在诊断甚至运动前标记物。
检索了截至2015年10月的PubMed数据库，并全面总结了关于PD中皮肤相关问题的现有证据。
总结了脂溢性皮炎、出汗功能障碍、大疱性类天疱疮和恶性黑色素瘤的患病率、病因及管理方面的证据，以及与治疗相关的皮肤疾病，特别是在金刚烷胺、罗替戈汀、阿扑吗啡和左旋多巴/卡比多巴肠凝胶治疗以及脑深部刺激中观察到的那些。还讨论了评估α-突触核蛋白的存在、皮肤神经的密度和形态以及皮肤成纤维细胞功能的皮肤活检。
皮肤疾病是PD的常见表现。然而，这些疾病的确切病理生理学和患病率尚未完全明确，在这方面需要更系统的研究。作为PD诊断标记物的外周组织活检是未来PD研究中一个令人兴奋的途径，尽管在将其用于常规临床实践之前还需要解决多个注意事项和未决问题。
