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化脓性汗腺炎和银屑病的共病率:详细的人口统计学、疾病严重程度和合并症模式。

Coprevalence of Hidradenitis Suppurativa and Psoriasis: Detailed Demographic, Disease Severity and Comorbidity Pattern.

机构信息

Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt, Frankfurt am Main, Germany,

Department of Dermatology, Hospital Darmstadt, Darmstadt, Germany.

出版信息

Dermatology. 2021;237(5):759-768. doi: 10.1159/000511868. Epub 2020 Dec 16.

Abstract

BACKGROUND AND OBJECTIVES

Hidradenitis suppurativa (HS) and plaque psoriasis (Pso) are supposed to have a coprevalence. However, data showing a more detailed description of patients with both diseases are rare. In this study, we characterized patients with both skin diseases in terms of onset, disease course, severity, concomitant diseases and therapeutical management.

PATIENTS AND METHODS

Data from 28 patients with a confirmed codiagnosis of HS and Pso from 2 university hospitals presented between 2015 and 2019 were evaluated retrospectively. For further characterization, patients were divided into different cohorts depending on whether HS or Pso was diagnosed as the first disease.

RESULTS

The average age of patients with a coprevalence of both diseases was 44.4 years with a female/male ratio of 1:1.15. Fifteen patients were diagnosed first with HS at an average age of 22.8 years, 13 patients first showed symptoms of Pso at a mean age of 21.7 years. The average time to the onset of the corresponding second disease was 14.3 years. Patients with HS as first disease showed a significantly severer form of HS compared to patients with a first diagnosis of Pso (mean highest International Hidradenitis Suppurativa Severity Score System: 23.5 vs. 8.2; p = 0.02). Severity of psoriatic disease in patients with HS at first diagnosis was numerically lower but not significant compared to the cohort with Pso at first diagnosis (mean highest Psoriasis Area and Severity Index: 7.8 vs. 13.2; p = 0.299). The most frequent comorbidity in all patients was obesity (64.3%; mean body mass index: 32.2) followed by psychiatric complaints (25%) and psoriatic arthritis (21.4%). Adalimumab was the most commonly used drug that had a positive effect on both diseases, HS and Pso.

CONCLUSIONS

In patients with a coprevalence of HS and Pso, the disease which occurs first appears to take a severer course, with an increased risk of development of obesity and psychiatric comorbidity in both cohorts.

摘要

背景与目的

化脓性汗腺炎(HS)和斑块型银屑病(Pso)被认为具有共同发病。然而,很少有数据详细描述同时患有这两种疾病的患者。在这项研究中,我们根据发病时间、疾病进程、严重程度、合并症和治疗管理来描述同时患有这两种皮肤病的患者。

患者与方法

回顾性分析了 2015 年至 2019 年期间在 2 所大学医院确诊为 HS 和 Pso 共病的 28 例患者的数据。为了进一步描述,根据 HS 或 Pso 是先诊断为哪种疾病,将患者分为不同的队列。

结果

同时患有这两种疾病的患者的平均年龄为 44.4 岁,男女比例为 1:1.15。15 例患者平均年龄为 22.8 岁时首次被诊断为 HS,13 例患者平均年龄为 21.7 岁时首次出现 Pso 症状。相应的第二种疾病发病的平均时间为 14.3 年。与先诊断为 Pso 的患者相比,先诊断为 HS 的患者 HS 表现出更严重的形式(平均最高国际化脓性汗腺炎严重程度评分系统:23.5 比 8.2;p = 0.02)。在首次诊断为 HS 的患者中,银屑病疾病的严重程度虽然较低,但与首次诊断为 Pso 的患者相比没有统计学意义(平均最高银屑病面积和严重程度指数:7.8 比 13.2;p = 0.299)。所有患者中最常见的合并症是肥胖(64.3%;平均体重指数:32.2),其次是精神科投诉(25%)和银屑病关节炎(21.4%)。阿达木单抗是最常用的药物,对 HS 和 Pso 都有积极作用。

结论

在同时患有 HS 和 Pso 的患者中,先发生的疾病似乎病程更严重,两队列肥胖和精神科合并症的发展风险增加。

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