Libon F, Lebas E, El Hayderi L, De Schaetzen V, Dezfoulian B, Nikkels A F
Service de Dermatologie et de Vénéréologie, CHU Liège, Belgique.
Rev Med Liege. 2020 May;75(5-6):376-381.
Psoriasis is a chronic inflammatory skin disease affecting around 2-3 % of the population. The disease spectrum evolves from to the knees and elbows limited disease to erythrodermic psoriasis. The impact on the quality of life, the pruritus, the pain from palmo-plantar disease, arthropathic psoriasis and the comorbidities are the major complaints of the patients. The treatment relies on topical treatments with dermocorticosteroids with or without vitamin D derivatives, UVA or UVB phototherapy, conventional treatments including methotrexate, ciclosporin and acitretin, and, since around 15 years, biological treatments. The biological treatments for moderate to severe psoriasis progressed in a spectacular way with an improvement of clinical results and an amelioration of the safety profile at every step. This article discusses these developments from the TNF? antagonists, including etanercept, adalimumab and infliximab to the newly arrivals, the anti-IL17 and anti-IL23 antagonists, the anti-PDE-4 antagonists and the JAK inhibitors.
银屑病是一种慢性炎症性皮肤病,影响着约2%-3%的人口。疾病谱从局限于膝盖和肘部的疾病发展到红皮病型银屑病。对生活质量的影响、瘙痒、掌跖疾病引起的疼痛、关节病型银屑病以及合并症是患者的主要诉求。治疗方法包括使用含或不含维生素D衍生物的皮质类固醇进行局部治疗、UVA或UVB光疗、包括甲氨蝶呤、环孢素和阿维A在内的传统治疗,以及大约15年来的生物治疗。中重度银屑病的生物治疗取得了惊人的进展,临床疗效不断改善,安全性也在每一步都有所提高。本文讨论了这些进展,从肿瘤坏死因子(TNF)拮抗剂,包括依那西普、阿达木单抗和英夫利昔单抗,到新出现的抗IL-17和抗IL-23拮抗剂、抗磷酸二酯酶-4(PDE-4)拮抗剂和Janus激酶(JAK)抑制剂。