Pouw Juliëtte N, Leijten Emmerik F A, Tekstra Janneke, Balak Deepak M W, Radstake Timothy R D J
UMC Utrecht, afd. Reumatologie en Klinische Immunologie, Utrecht.
Contact: J.N. Pouw (
Ned Tijdschr Geneeskd. 2019 Jul 29;163:D3936.
Psoriasis is a common immune-mediated inflammatory condition that primarily affects skin and nails. 6-41% of psoriasis patients develop psoriatic arthritis (PsA). The ways in which PsA can manifest itself include peripheral arthritis, axial spondyloarthritis, dactylitis and enthesitis. This heterogeneous clinical picture makes it sometimes difficult to recognise PsA,potentially resulting in permanent joint damage and functional impairments. Some people see psoriasis and PsA as 2 manifestations of a single disease because the multifactorial origins of psoriasis and PsA are largely overlapping. Psoriatic conditions are associated with a high burden of disease, reduced quality of life and comorbidities, including psychiatric and cardiovascular conditions. In recent years, several immunological pathways, immune cells and cytokines have been identified as important factors in pathophysiology and as new therapeutic targets. For many PsA patients treatment with disease modifying anti-rheumatic drugs leads to significant improvement of symptoms and quality of life.
银屑病是一种常见的免疫介导的炎症性疾病，主要影响皮肤和指甲。6%-41%的银屑病患者会发展为银屑病关节炎（PsA）。PsA的表现形式包括外周关节炎、中轴型脊柱关节炎、指（趾）炎和附着点炎。这种异质性的临床表现有时使得PsA难以识别，可能导致永久性关节损伤和功能障碍。一些人将银屑病和PsA视为单一疾病的两种表现形式，因为银屑病和PsA的多因素起源在很大程度上相互重叠。银屑病相关疾病负担高，生活质量下降，还伴有多种合并症，包括精神疾病和心血管疾病。近年来，几种免疫途径、免疫细胞和细胞因子已被确定为病理生理学中的重要因素和新的治疗靶点。对于许多PsA患者来说，使用改善病情的抗风湿药物治疗可显著改善症状和生活质量。
