Department of Dermatology, Aksaray University Faculty of Medicine, Aksaray, Turkey.
Department of Dermatology, Health Science University Ankara City Hospital, Ankara, Turkey.
An Bras Dermatol. 2022 Jan-Feb;97(1):22-27. doi: 10.1016/j.abd.2021.05.008. Epub 2021 Nov 14.
Previous studies has shown that dry eye test abnormalities, meibomian gland dysfunction (MGD), may occur in psoriasis.
The authors aimed to evaluate the dry eye disease (DED), MGD, in psoriasis patients with meibography which is a current, objective, noninvasive method for patients with meibomian gland diseases, to investigate the relationship between disease severity and ocular involvement.
This study included 50 participants with psoriasis and 50 healthy individuals. All subjects were examined by the same dermatologist and referred for ophthalmological examination including meibomian gland obstruction, lid margin alterations assessment, ocular surface disease index assessment, tear film break-up time test, Schirmer test, corneal conjunctival fluorescein staining assessment. Additionally, upper and lower lids were evaluated for meibomian gland loss with meibography.
MGD (28%), meibomian gland loss (MGL) (29.5%), upper meiboscore (0.61 ± 0.81), lower meiboscore (0.46 ± 0.61), DED (22%) were significantly higher in the psoriasis group compared with the control group (p = 0.008, p < 0.001, p = 0.027, p = 0.041, p = 0.044, respectively). There was a significant relationship between MGD and psoriasis area severity index (PASI) (p = 0.015, Odds Ratio = 1.211). There was a significant positive relationship between MGL with PASI (p < 0.001, r = 608) and psoriasis duration (p < 0.001, r = 0.547).
Smaller study group and inability to detect quality changes of meibum with meibography were limitations of the study.
Psoriasis may affect the meibomian gland morphology, may cause structural changes in meibomian glands, and as a result of these may cause MGD and DED. Therefore, ophthalmologists and dermatologists should be aware of this situation and co-evaluate the patients in this respect.
先前的研究表明,干眼症测试异常、睑板腺功能障碍(MGD)可能发生在银屑病中。
作者旨在通过当前客观、非侵入性的睑板腺疾病检查方法——睑板腺照相术,评估银屑病患者的干眼疾病(DED)、MGD,以研究疾病严重程度与眼部受累之间的关系。
本研究纳入 50 例银屑病患者和 50 例健康对照者。所有患者均由同一位皮肤科医生检查,并转诊进行眼科检查,包括睑板腺阻塞、眼睑边缘改变评估、眼表疾病指数评估、泪膜破裂时间测试、泪液分泌试验、角膜结膜荧光素染色评估。此外,通过睑板腺照相术评估上下眼睑的睑板腺缺失。
与对照组相比,银屑病组 MGD(28%)、睑板腺缺失(MGL)(29.5%)、上睑板腺评分(0.61±0.81)、下睑板腺评分(0.46±0.61)、DED(22%)显著更高(p=0.008、p<0.001、p=0.027、p=0.041、p=0.044)。MGD 与银屑病面积严重指数(PASI)之间存在显著相关性(p=0.015,优势比=1.211)。MGL 与 PASI(p<0.001,r=608)和银屑病病程(p<0.001,r=0.547)之间存在显著正相关。
研究的局限性在于研究组较小且无法用睑板腺照相术检测睑脂质量变化。
银屑病可能影响睑板腺形态,可能导致睑板腺结构改变,进而导致 MGD 和 DED。因此,眼科医生和皮肤科医生应意识到这种情况,并在这方面共同评估患者。