Department of Dermatology, Chang Gung Memorial Hospital, Linkou.
College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Indian J Dermatol Venereol Leprol. 2021 Mar-Apr;87(2):223-226. doi: 10.4103/ijdvl.IJDVL_455_18.
Psoriasis and hidradenitis suppurativa are inflammatory dermatoses that have been associated with arthritis, metabolic syndrome, obesity, and smoking. They share common pathogenic mechanisms such as elevated levels of several proinflammatory cytokines including tumor necrosis factor (TNF), interleukin-17A, and impaired Notch pathway. Thus, treatments for both diseases are sometimes overlapping. Biological therapy such as adalimumab is effective for patients with hidradenitis suppurativa and psoriasis. Adalimumab is a monoclonal antibody that binds to TNF and inhibits the cytokine interaction with the TNF receptors, thus inhibiting the inflammatory cascade. Currently, data are lacking on the treatment for co-occurrence of psoriasis and hidradenitis suppurativa. This case series describes three patients with a diagnosis of concomitant psoriasis and hidradenitis suppurativa. In these cases, after 12 weeks of treatment with adalimumab 40 mg every other week, the average Psoriasis Area Severity Index score reduced from 21.4 to 2.9 for psoriasis, Hidradenitis Suppurativa-Physician's Global Assessment from 3.3 to 0.7, and pain Visual Analog Scale for hidradenitis suppurativa from 4.6 to 2. The results suggest that adalimumab is a treatment of choice for patients with concomitant hidradenitis suppurativa and psoriasis.
银屑病和化脓性汗腺炎是两种炎症性皮肤病,它们与关节炎、代谢综合征、肥胖和吸烟有关。它们具有共同的发病机制,如包括肿瘤坏死因子 (TNF)、白细胞介素-17A 在内的几种促炎细胞因子水平升高,以及 Notch 通路受损。因此,这两种疾病的治疗有时会重叠。阿达木单抗等生物疗法对化脓性汗腺炎和银屑病患者有效。阿达木单抗是一种单克隆抗体,可与 TNF 结合并抑制细胞因子与 TNF 受体的相互作用,从而抑制炎症级联反应。目前,对于银屑病和化脓性汗腺炎同时发生的治疗数据尚缺乏。本病例系列描述了 3 例同时诊断为银屑病和化脓性汗腺炎的患者。在这些病例中,阿达木单抗(每两周 40mg)治疗 12 周后,银屑病的平均银屑病面积严重程度指数评分从 21.4 降至 2.9,化脓性汗腺炎医生整体评估从 3.3 降至 0.7,化脓性汗腺炎疼痛视觉模拟评分从 4.6 降至 2。结果表明,阿达木单抗是同时患有化脓性汗腺炎和银屑病患者的治疗选择。