Department of Dermatology, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India.
Dermatology Services Department, KK Women's and Children's Hospital, Singapore.
Indian J Dermatol Venereol Leprol. 2021;87(4):522-527. doi: 10.4103/ijdvl.IJDVL_655_18.
Face was often thought to be spared in psoriasis possibly due to the protective effect of sebum and low-dose ambient ultraviolet radiation exposure. Some have suggested that facial involvement is common and indicates disease severity. There is a paucity of data on this, particularly from India. Psoriatics have a higher prevalence of metabolic syndrome, and patients with severe disease are at greater risk.
A study of the frequency and type of facial involvement in Indian psoriatic patients and its association with disease severity and metabolic syndrome.
A total of 250 consecutive psoriatic patients were screened and these yielded 188 patients with facial involvement. Facial psoriatics were divided into peripherofacial, centrofacial and mixed facial types. Disease severity was assessed using whole body, scalp, facial psoriasis area severity index scores and nail area psoriasis severity index scores. Patients were evaluated for the presence of metabolic syndrome using NCEP-III criteria. All parameters were compared both between facial and nonfacial psoriatics and between cases with different types of face involvement.
The mean age (P = 0.04) and age of onset of disease (P = 0.02) was lower and median whole-body psoriasis area severity index score was higher in psoriatics with facial involvement (P < 0.001) than those without. No significant association was found between facial involvement and metabolic syndrome. Mixed facial was the commonest type of facial involvement and there was a significant association of mixed facial involvement with increased total body psoriasis area severity index scores (P < 0.001).
Dietary habits, physical activity level, family history of diabetes and obesity were not enquired for in our patients. Centrofacial cases were too few in number, hence statistical comparisons are not relevant.
Facial involvement in psoriatics is associated with severe disease but not metabolic syndrome. Mixed facial type might be considered a marker of overall psoriasis disease severity in the Indian population.
人们常认为银屑病皮损通常不会累及面部，这可能是由于皮脂的保护作用和低剂量环境紫外线辐射暴露。一些人认为面部受累较为常见，且表明疾病严重程度。然而，这方面的数据很少，特别是来自印度的研究数据。银屑病患者代谢综合征的患病率较高，病情严重的患者风险更大。
研究印度银屑病患者面部受累的频率、类型及其与疾病严重程度和代谢综合征的关系。
共筛查了 250 例连续的银屑病患者，其中有 188 例患者存在面部受累。将面部银屑病患者分为外周型、中央型和混合性。采用全身、头皮、面部银屑病面积严重指数评分和指甲面积银屑病严重指数评分评估疾病严重程度。采用 NCEP-III 标准评估代谢综合征的存在。比较面部和非面部银屑病患者、不同类型面部受累患者之间的所有参数。
与无面部受累的银屑病患者相比，有面部受累的银屑病患者的平均年龄（P = 0.04）和发病年龄（P = 0.02）更低，中位全身银屑病面积严重指数评分更高（P < 0.001）。面部受累与代谢综合征之间无显著相关性。混合性是最常见的面部受累类型，与全身性银屑病面积严重指数评分增加有显著相关性（P < 0.001）。
我们的患者未询问饮食习惯、身体活动水平、糖尿病和肥胖的家族史。中央型病例数量太少，因此无法进行统计学比较。
银屑病患者的面部受累与疾病严重程度有关，但与代谢综合征无关。混合性面部类型可能被认为是印度人群整体银屑病疾病严重程度的标志。
