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银屑病瘙痒:老话题的新视角。

Itch in Psoriasis: A New Look at Well-known Subject.

机构信息

Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland.

出版信息

Acta Derm Venereol. 2019 Apr 1;99(4):429-434. doi: 10.2340/00015555-3147.

Abstract

Psoriasis is a chronic inflammatory dermatosis, frequently presenting with chronic itch. This study investigated the prevalence and detailed clinical characteristics of chronic itch in 143 psoriatic patients, with regard to different age groups, comorbidities and pharmacotherapy. Chronic itch was reported by 72% of subjects. Patients aged 65 years and over presented higher 4-Item Itch Questionnaire (4IIQ) scores (8.6 ± 3.4 vs. 7.4 ± 2.5 points; p = 0.03) and rarely experienced itching at midday (p = 0.009). Chronic itch correlated with aspirin intake and xerosis intensity. 4IIQ scores were higher in patients with asthma/chronic obstructive pulmonary disease, peptic ulcer disease and those taking insulin. Logistic regression analysis found that chronic itch was positively correlated with the use of antacids, angiotensin receptor blockers, angiotensin enzyme converting inhibitors, beta-blockers, xerosis intensity and Physician's Global Assessment score, whereas psychiatric drugs other than selective serotonin reuptake inhibitors, allopurinol, coexistence of arterial hypertension and application of emollients acted conversely. Elderly psoriatic patients present several differences in the characteristics of chronic itch, and chronic itch may be associated with comorbidities and pharmacotherapy. To the best of our knowledge, this is the first study to report possible associations between psoriatic pruritus and co-administration of drugs utilized in various systemic conditions.

摘要

银屑病是一种慢性炎症性皮肤病,常伴有慢性瘙痒。本研究调查了 143 例银屑病患者中慢性瘙痒的患病率及详细的临床特征,包括不同年龄组、合并症和药物治疗情况。72%的患者报告有慢性瘙痒。65 岁及以上的患者 4-Item Itch Questionnaire(4IIQ)评分较高(8.6±3.4 分比 7.4±2.5 分;p=0.03),很少在中午感到瘙痒(p=0.009)。慢性瘙痒与阿司匹林摄入和皮肤干燥程度有关。哮喘/慢性阻塞性肺疾病、消化性溃疡病和使用胰岛素的患者 4IIQ 评分较高。Logistic 回归分析发现,慢性瘙痒与使用抗酸药、血管紧张素受体阻滞剂、血管紧张素酶抑制剂、β受体阻滞剂、皮肤干燥程度和医生总体评估评分呈正相关,而除选择性 5-羟色胺再摄取抑制剂外的精神药物、别嘌醇、并存的动脉高血压和使用保湿剂则相反。老年银屑病患者的慢性瘙痒特征存在一些差异,慢性瘙痒可能与合并症和药物治疗有关。据我们所知,这是第一项报告银屑病瘙痒可能与各种系统疾病中使用的药物联合应用有关的研究。

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