银屑病与皮肤屏障功能障碍：温和清洁剂和保湿剂在银屑病治疗中的作用。

Psoriasis and Skin Barrier Dysfunction: The Role of Gentle Cleansers and Moisturizers in Treating Psoriasis.

出版信息

J Drugs Dermatol. 2023 Aug 1;22(8):773-778. doi: 10.36849/jdd.7411.

Abstract

BACKGROUND

Psoriasis is a chronic immune-mediated dermatologic disorder with multisystemic comorbidities, which is effectively treated with a range of prescription therapies. Studies have reported epidermal barrier abnormalities in the lesional skin of psoriasis patients; however, there is currently insufficient information about skin barrier function in psoriasis patients. This review discusses the potential role of gentle cleansers and moisturizers in the management of psoriasis and in promoting a healthy skin barrier.

METHODS

A literature review was followed by the authors' discussions and agreement on 5 statements to provide expert guidance for gentle cleansers and moisturizer use in psoriasis patients.

RESULTS

In a workshop, the authors provided feedback on 15 draft statements created prior to the meeting, and agreed upon 5 statements. The authors agreed that guidelines rarely mention skincare for psoriasis patients, demonstrating a potential knowledge gap. Skincare may play a role in managing psoriasis as an adjuvant treatment of acute psoriasis and for maintenance treatment of healing skin during asymptomatic periods. Studies of patients with psoriasis applying topical moisturizers (such as those containing salicylic acid or ceramides) showed softened plaques, enhancing the absorption of topical treatments such as corticosteroids. Studies applying ceramide-containing skincare showed an overall improvement in the appearance of the skin and provided relief for psoriasis.

CONCLUSION

The authors agreed that skincare and barrier restoration in treating psoriasis is a relatively new concept for most dermatologists. There is a need to develop a more robust body of evidence on skincare for psoriasis to influence clinical practice in a meaningful way. Kircik L, Alexis AF, Andriessen A, et al. Psoriasis and skin barrier dysfunction: the role of gentle cleansers and moisturizers in treating psoriasis. J Drugs Dermatol. 2023;22(8):773-778. doi:10.36849/JDD.7411.

摘要

背景

银屑病是一种慢性免疫介导的皮肤病，伴有多种系统合并症，可通过一系列处方疗法有效治疗。研究报告称，银屑病患者皮损皮肤存在表皮屏障异常；然而，目前关于银屑病患者皮肤屏障功能的信息还不够充分。本综述讨论了温和清洁剂和保湿剂在银屑病管理以及促进健康皮肤屏障方面的潜在作用。

方法

作者对文献进行了综述，并对 5 项声明进行了讨论和一致意见，为银屑病患者使用温和清洁剂和保湿剂提供专家指导。

结果

在研讨会上，作者对会前会议生成的 15 份草稿声明提供了反馈，并达成了 5 项声明。作者一致认为，指南很少提及银屑病患者的护肤，这表明存在潜在的知识差距。护肤可能在管理银屑病方面发挥作用，作为急性银屑病的辅助治疗以及在无症状期间维持治疗愈合皮肤。研究表明，银屑病患者使用局部保湿剂（如含有水杨酸或神经酰胺的保湿剂）可使斑块软化，增强皮质类固醇等局部治疗药物的吸收。使用含有神经酰胺的护肤产品可整体改善皮肤外观，缓解银屑病症状。

结论

作者一致认为，在治疗银屑病时，皮肤护理和屏障修复是大多数皮肤科医生相对较新的概念。需要开发更多关于银屑病皮肤护理的循证医学证据，以有意义的方式影响临床实践。Kircik L, Alexis AF, Andriessen A, et al. Psoriasis and skin barrier dysfunction: the role of gentle cleansers and moisturizers in treating psoriasis. J Drugs Dermatol. 2023;22(8):773-778. doi:10.36849/JDD.7411.