Department of Dermatology, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Division of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
J Formos Med Assoc. 2023 Jun;122(6):442-457. doi: 10.1016/j.jfma.2022.10.010. Epub 2022 Nov 5.
Psoriatic disease is a chronic inflammatory disorder with skin and joint manifestations. Due to the persistent inflammatory state exhibited by patients with psoriasis, multiple systemic comorbidities occur more frequently in patients with psoriasis than in the general population, and the risk of cardiovascular (CV) diseases is significantly increased. As the pathophysiology of psoriatic disease is becoming better understood, the sharing of underlying pathogenic mechanisms between psoriatic and CV diseases is becoming increasingly apparent. Consequently, careful attention to CV comorbidities that already exist or may potentially develop is needed in the management of patients with psoriasis, particularly in the screening and primary prevention of CV disease and in treatment selection due to potential drug-drug and drug-disease interactions. Furthermore, as the use of effective biologic therapy and more aggressive oral systemic treatment for psoriatic disease is increasing, consideration of the potential positive and negative effects of oral and biologic treatment on CV disease is warranted. To improve outcomes and quality of care for patients with psoriasis, the Taiwanese Dermatological Association, the Taiwanese Association for Psoriasis and Skin Immunology, and the Taiwan Society of Cardiology established a Task Force of 20 clinicians from the fields of dermatology, cardiology, and rheumatology to jointly develop consensus expert recommendations for the management of patients with psoriatic disease with attention to CV comorbidities.
银屑病是一种慢性炎症性疾病，可累及皮肤和关节。由于银屑病患者持续存在炎症状态，与一般人群相比，银屑病患者更容易发生多种系统性合并症，且心血管（CV）疾病的风险显著增加。随着对银屑病发病机制的深入了解，银屑病与 CV 疾病之间的潜在发病机制的相关性日益明显。因此，在银屑病患者的管理中，需要仔细关注已经存在或可能发生的 CV 合并症，尤其是在 CV 疾病的筛查和一级预防以及治疗选择方面，因为可能存在药物相互作用和药物与疾病的相互作用。此外，随着针对银屑病的有效生物治疗和更积极的口服全身治疗的应用增加，有必要考虑口服和生物治疗对 CV 疾病的潜在积极和消极影响。为改善银屑病患者的结局和护理质量，台湾皮肤科医学会、台湾银屑病暨皮肤免疫学会及台湾心脏学会成立了一个由来自皮肤科、心脏病学和风湿病学领域的 20 名临床医生组成的专家组，共同制定了关注 CV 合并症的银屑病患者管理共识专家建议。
