Müller S, Schultes D, Wilsmann-Theis D
Klinik und Poliklinik für Dermatologie und Allergologie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.
Hautarzt. 2020 Mar;71(3):227-243. doi: 10.1007/s00105-020-04555-w.
In Germany, approximately 2% of the population suffers from psoriasis, which is no longer considered only a cutaneous, but rather a systemic disease. Accordingly, common comorbidities and potential joint involvement in psoriasis must be recorded. If necessary, interdisciplinary patient care has to be organized. The use of validated scores is recommended to complete the patient's medical history. The individual treatment should include intensified topical therapies as well as short-term phototherapy in case of an acute phase. In addition to conventional systemic therapies (e.g., fumarates, methotrexate), a number of new therapeutics for psoriasis are in development. Apart from the PDE‑4 inhibitor apremilast, targeted therapies are currently available to block TNF-alpha, IL-17A, the IL-17 receptor and IL-23. Decisions on individualized, patient-centered psoriasis management should be based on assessment of disease severity and the existence of comorbidities. Furthermore, economic aspects should be taken into account.
在德国，约2%的人口患有银屑病，该病不再仅被视为一种皮肤病，而是一种全身性疾病。因此，必须记录银屑病常见的合并症和潜在的关节受累情况。如有必要，必须组织跨学科的患者护理。建议使用经过验证的评分来完善患者的病史。个体治疗应包括强化局部治疗以及急性期的短期光疗。除了传统的全身治疗（如富马酸盐、甲氨蝶呤）外，一些治疗银屑病的新疗法正在研发中。除磷酸二酯酶4抑制剂阿普斯特外，目前还有靶向疗法可阻断肿瘤坏死因子-α、白细胞介素-17A、白细胞介素-17受体和白细胞介素-23。关于个体化、以患者为中心的银屑病管理决策应基于对疾病严重程度和合并症存在情况的评估。此外，还应考虑经济因素。
