性与性别在皮肤病学中的作用——从发病机制到临床意义。
The Role of Sex and Gender in Dermatology - From Pathogenesis to Clinical Implications.
机构信息
Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada.
Faculty of Medicine, McGill University, Montréal, Québec, Canada.
出版信息
J Cutan Med Surg. 2023 Jul-Aug;27(4):NP1-NP36. doi: 10.1177/12034754231177582. Epub 2023 Jul 4.
BACKGROUND
Sex and gender have increasingly been recognized as significant risk factors for many diseases, including dermatological conditions. Historically, sex and gender have often been grouped together as a single risk factor in the scientific literature. However, both may have a distinct impact on disease incidence, prevalence, clinical presentation, severity, therapeutic response, and associated psychological distress.
OBJECTIVES AND PROJECT DESCRIPTION
The mechanisms that underlie differences in skin diseases between males, females, men, and women remain largely unknown. The specific objectives of this review paper are:To highlight the biological differences between males and females (sex), as well as the sociocultural differences between men and women (gender) and how they impact the integumentary system.To perform a literature review to identify important sex- and gender-related epidemiological and clinical differences for various skin conditions belonging to a range of disease categories and to discuss possible biological and sociocultural factors that could explain the observed differences.To discuss dermatological skin conditions and gender-affirming treatments within the transgender community, a population of individuals who have a gender identity which is different than the gender identity they were assigned at birth.
FUTURE IMPACT
With the rising number of individuals that identify as non-binary or transgender within our increasingly diverse communities, it is imperative to recognize gender identity, gender, and sex as distinct entities. By doing so, clinicians will be able to better risk-stratify their patients and select treatments that are most aligned with their values. To our knowledge, very few studies have separated sex and gender as two distinct risk factors within the dermatology literature. Our article also has the potential to help guide future prevention strategies that are patient-tailored rather than using a universal approach.
背景
性别已日益被视为许多疾病(包括皮肤病)的重要风险因素。从历史上看,性别在科学文献中经常被视为单一风险因素。然而,性别和社会性别可能对疾病的发病率、患病率、临床表现、严重程度、治疗反应和相关心理困扰产生不同的影响。
目的和项目描述
导致男性、女性、男性和女性之间皮肤病存在差异的机制在很大程度上仍不清楚。本文的具体目标是:强调男性和女性之间(性别)的生物学差异,以及男性和女性之间(社会性别)的社会文化差异,以及它们如何影响皮肤系统。进行文献回顾,以确定各种皮肤状况的重要性别和性别相关的流行病学和临床差异,这些皮肤状况属于一系列疾病类别,并讨论可能解释观察到的差异的生物学和社会文化因素。讨论跨性别群体中的皮肤病和性别肯定治疗,跨性别群体是指那些其性别认同与其出生时被分配的性别认同不同的个体。
未来影响
随着我们日益多样化的社区中越来越多的人认同非二元性别或跨性别,认识到性别认同、性别和性是不同的实体至关重要。这样做,临床医生将能够更好地对患者进行风险分层,并选择最符合其价值观的治疗方法。据我们所知,在皮肤病学文献中,很少有研究将性别和社会性别作为两个独立的风险因素进行区分。我们的文章还有可能有助于指导未来的个体化患者预防策略,而不是采用普遍的方法。