Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy.
, Section of Endocrinology, Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy.
Minerva Endocrinol. 2020 Dec;45(4):345-353. doi: 10.23736/S0391-1977.20.03248-4. Epub 2020 Sep 24.
In the next future, dermatologists, endocrinologist and physicians may cope with the impact of extent SARS-CoV-2 (COVID-19) infection over chronic inflammatory skin diseases and their treatment. COVID-19 pandemic obliged many countries to impose social restrictions, resulting in the need to adapt daily lifestyle habits and working activities. These changes have drastically reduced physical activity and social interactions, with the possible increase of anxiety, eating disorders and weight gain.
We searched for relevant studies (trials, real-life studies and case reports, meta-analysis, pooled data analysis, reviews) on endocrine disorders and inflammatory skin diseases. The database used was PubMed. The studies included were those published in the English language between January 1, 2018 and May 5, 2020.
Several studies have been previously showed the association of overweight and obesity, with the metabolic syndrome and insulin-resistance. It has been demonstrated how these conditions correlate with the worsening of such chronic inflammatory skin diseases, such as psoriasis, hidradenitis suppurativa and acne. Many evidences suggest an important role of adipose tissue in the production of pro-inflammatory cytokines (Leptin, adiponectin, TNFα, IL-6, MCP-1, PAI-1), involved in the pathogenesis and the exacerbations of these skin diseases. In addition, we should expect an increasing incidence rate of hypovitaminosis D in the next future due to reduced sun exposure caused by isolation at home and missed holidays. Scientific evidences already show the important immunomodulating role of vitamin D in inflammatory skin diseases.
Our study pays attention on medium-long term effects of COVID-19 outbreak on inflammatory skin disorders, due to the lifestyle changes. In such context this review considers how a multidisciplinary approach, involving dermatologists, nutritionists and endocrinologists, may lead to a better management of dermatologic patients.
在未来，皮肤科医生、内分泌学家和内科医生可能需要应对 COVID-19（严重急性呼吸综合征冠状病毒 2）对慢性炎症性皮肤病及其治疗的影响。COVID-19 大流行迫使许多国家实施社会限制，导致人们需要改变日常生活习惯和工作活动。这些变化极大地减少了身体活动和社交互动，可能会增加焦虑、饮食失调和体重增加。
我们搜索了与内分泌疾病和炎症性皮肤病相关的研究（试验、真实世界研究和病例报告、荟萃分析、汇总数据分析、综述）。使用的数据库是 PubMed。纳入的研究为 2018 年 1 月 1 日至 2020 年 5 月 5 日期间发表的英文文献。
之前有几项研究表明超重和肥胖与代谢综合征和胰岛素抵抗有关。已经证明了这些情况如何与慢性炎症性皮肤病（如银屑病、化脓性汗腺炎和痤疮）的恶化相关。许多证据表明脂肪组织在产生促炎细胞因子（瘦素、脂联素、TNFα、IL-6、MCP-1、PAI-1）方面起着重要作用，这些细胞因子参与这些皮肤病的发病机制和加重。此外，由于在家隔离和错过假期导致阳光照射减少，我们预计在未来不久，维生素 D 缺乏症的发病率将会增加。科学证据已经表明维生素 D 在炎症性皮肤病中的重要免疫调节作用。
我们的研究关注 COVID-19 爆发对炎症性皮肤疾病的中长期影响，原因是生活方式的改变。在这种情况下，本综述考虑了皮肤科医生、营养师和内分泌学家的多学科方法如何有助于更好地管理皮肤科患者。
