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银屑病的心血管共病 - 银屑病炎症不只是皮肤问题。

Cardiovascular comorbidity in psoriasis - psoriatic inflammation is more than just skin deep.

机构信息

Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany.

Division of Chronic Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany.

出版信息

J Dtsch Dermatol Ges. 2023 Jul;21(7):718-725. doi: 10.1111/ddg.15071. Epub 2023 Apr 26.

Abstract

BACKGROUND

There is a growing understanding of inflammation in psoriasis beyond its dermatological manifestation, towards systemic inflammation. Management of possible comorbidities encompassing psychological, metabolic and cardiovascular disease is recommended in national and international dermatology guidelines for treatment of psoriasis patients. Vice versa, psoriasis is being recognized as a new risk factor for cardiovascular inflammation within the cardiological community.

METHODS

A review of the literature was conducted. Key points regarding epidemiological, mechanistic and management aspects were summarized and put into context for physicians treating psoriasis patients.

RESULTS

Efforts are currently being made to better understand the mechanistic underpinnings of systemic inflammation within psoriatic inflammation. Studies looking to "hit two birds with one stone" regarding specifically cardiovascular comorbidities of psoriasis patients using established systemic dermatological therapies have so far provided heterogeneous data. The diagnosis of psoriasis entails preventive and therapeutic consequences regarding concomitant diseases for the individual patient.

CONCLUSIONS

The knowledge of comorbidities in psoriasis calls for pronounced interdisciplinary care of psoriasis patients, to which this article highlights efforts regarding vascular inflammation and cardiovascular disease.

摘要

背景

人们对银屑病的炎症认识已经超越了其皮肤表现,开始关注全身性炎症。国家和国际皮肤病学指南建议对银屑病患者进行可能的合并症(包括心理、代谢和心血管疾病)的管理。反过来,心血管医学领域也开始认识到银屑病是心血管炎症的一个新的危险因素。

方法

进行了文献回顾。总结了与银屑病患者治疗相关的流行病学、发病机制和管理方面的要点,并将其置于背景中。

结果

目前正在努力更好地理解银屑病炎症中系统性炎症的发病机制。一些研究试图使用已建立的全身性皮肤病治疗方法,“一石二鸟”地解决银屑病患者的心血管合并症问题,但迄今为止提供的数据存在异质性。诊断为银屑病意味着对个体患者的合并症进行预防和治疗。

结论

银屑病合并症的知识要求对银屑病患者进行明显的跨学科护理,本文重点介绍了针对血管炎症和心血管疾病的努力。

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