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儿童银屑病的管理:治疗进展与挑战——综述

Managing pediatric psoriasis: update on treatments and challenges-a review.

作者信息

Hebert A A, Browning J, Kwong P C, Duarte A M, Price H N, Siegfried E

机构信息

UTHealth McGovern Medical School, Houston, TX, USA.

UT Health San Antonio, San Antonio, TX, USA.

出版信息

J Dermatolog Treat. 2022 Aug;33(5):2433-2442. doi: 10.1080/09546634.2022.2059051. Epub 2022 Jul 18.

Abstract

BACKGROUND

Psoriasis is a chronic, immune-mediated inflammatory disease with prominent cutaneous features, although the limited number of medications approved for pediatric psoriasis makes treating this population difficult. This review provides an overview of the challenges associated with diagnosing and treating pediatric psoriasis as well as the approved and off-label treatments for children and infants with psoriasis.

METHODS

Articles relevant to pediatric psoriasis were identified using a series of PubMed searches. Topics relevant to pediatric psoriasis were explored, including disease characteristics, epidemiology, treatment efficacy and safety, and access to care. Publications previously known to the authors were also included.

RESULTS

Clinical features of psoriasis can be challenging to identify clinically, and patients face challenges gaining access to treatment. Most medications that have been approved for adult psoriasis lack data and labeling to support safe and effective use in pediatric patients, and therefore access is limited. A growing number of clinical trials using biologic agents for pediatric psoriasis aim to broaden available treatment options but may also raise unique concerns associated with the use of these medications in children.

CONCLUSION

Pediatric psoriasis is underrecognized and often undertreated. Clinicians must balance relative risks and potential benefits when developing a treatment strategy for these patients.

摘要

背景

银屑病是一种慢性、免疫介导的炎症性疾病,具有显著的皮肤特征,尽管获批用于儿童银屑病的药物数量有限,使得治疗这一人群颇具难度。本综述概述了儿童银屑病诊断和治疗相关的挑战,以及针对儿童和婴儿银屑病的获批治疗方法和未获批准但可使用的治疗方法。

方法

通过一系列PubMed检索确定与儿童银屑病相关的文章。探讨了与儿童银屑病相关的主题,包括疾病特征、流行病学、治疗效果和安全性以及获得治疗的途径。作者之前已知的出版物也被纳入。

结果

银屑病的临床特征在临床上难以识别,患者在获得治疗方面面临挑战。大多数已获批用于成人银屑病的药物缺乏支持在儿科患者中安全有效使用的数据和标签,因此治疗途径有限。越来越多使用生物制剂治疗儿童银屑病的临床试验旨在拓宽可用的治疗选择,但也可能引发与在儿童中使用这些药物相关的独特问题。

结论

儿童银屑病未得到充分认识,且常常治疗不足。临床医生在为这些患者制定治疗策略时必须权衡相对风险和潜在益处。

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