Fotiadou Christina, Lazaridou Elizabeth
Second Department of Dermatology-Venereology, Aristotle University Medical School, Thessaloniki, Greece.
Psoriasis (Auckl). 2019 Aug 28;9:91-96. doi: 10.2147/PTT.S179182. eCollection 2019.
Uveitis, an inflammatory disorder of the mid-portion of the eye, is considered a relatively rare but very serious ocular complication of psoriasis. Data on the specific characteristics of uveitis in the background of psoriasis are extremely limited. The presence of uveitis in the context of psoriasis has been estimated to occur in 7-20% of the psoriasis cases. This incidence tends to be higher in patients suffering from psoriasis and psoriatic arthritis (PsA) or PSA alone. Psoriatic uveitis is usually bilateral, chronic, and severe. In term of pathogenesis, both psoriasis and uveitis are considered as paradigms of T-helper 1/T-helper 17 (Th1/Th17) inflammatory reactions. Certain cytokines such as tumor necrosis factor-α (TNF- α), Interleukin-17 (IL-17), IL-23, and IL-6 play a significant role in the pathogenesis of both psoriasis and uveitis. As uveitis shares common pathogenetic mechanisms with psoriasis in certain circumstances, both diseases may benefit from the same targeted biologic therapies. Undiagnosed and under-treated cases of psoriatic uveitis may cause significant morbidity and even vision loss. Larger prospective studies are needed in order to further investigate the association between these two entities.
葡萄膜炎是一种眼部中间部分的炎症性疾病,被认为是银屑病相对罕见但非常严重的眼部并发症。关于银屑病背景下葡萄膜炎的具体特征的数据极为有限。据估计,银屑病患者中葡萄膜炎的发生率为7%至20%。在患有银屑病和银屑病关节炎(PsA)或仅患有PsA的患者中,这一发生率往往更高。银屑病性葡萄膜炎通常是双侧的、慢性的且严重的。在发病机制方面,银屑病和葡萄膜炎都被视为辅助性T细胞1/辅助性T细胞17(Th1/Th17)炎症反应的范例。某些细胞因子,如肿瘤坏死因子-α(TNF-α)、白细胞介素-17(IL-17)、IL-23和IL-6在银屑病和葡萄膜炎的发病机制中都起着重要作用。由于在某些情况下葡萄膜炎与银屑病具有共同的发病机制,这两种疾病可能都受益于相同的靶向生物疗法。银屑病性葡萄膜炎未被诊断和治疗不足的病例可能会导致严重的发病甚至视力丧失。需要进行更大规模的前瞻性研究,以进一步调查这两种疾病之间的关联。