Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Department of Dermatology, Nippon Medical School Hospital, Tokyo, Japan.
J Dermatol. 2024 Feb;51(2):185-195. doi: 10.1111/1346-8138.17049. Epub 2023 Dec 17.
Psoriasis is a long-lasting skin disease that primarily affects the skin, nails, and joints and is characterized by inflammation. Genetic factors contribute to its development and environmental triggers can worsen symptoms. Pathologically, psoriasis is characterized by uncontrolled keratinocyte proliferation and abnormal differentiation, and histological features include acanthosis with inflammatory cell infiltration and neovascularization. Psoriasis often starts in childhood, with about one-third of cases beginning during this time. Its prevalence steadily increases from the ages of 1 to 18 years in a linear fashion. Young people with psoriasis often require treatment throughout their childhood and adolescence, and into adulthood. However, prolonged treatment may increase the risk of complications and adverse events, so it is important to adopt an effective treatment approach that minimizes this risk. In addition, psoriasis is often associated with various comorbidities that may place a great burden on the physical and mental health of the children beyond those due to psoriasis itself. To ensure good long-term health outcomes, individuals with psoriasis should undergo regular screening. Treatment should be provided not only for skin lesions, but also for any comorbidities; however, currently there is not enough evidence on the treatment of pediatric psoriasis and no globally agreed-on guidelines exist for treating psoriasis in children. This article describes the etiology, clinical symptoms, and disease burden of pediatric psoriasis, the pathological conditions and diagnosis of plaque psoriasis, psoriatic arthritis, and generalized pustular psoriasis, and the available treatments for these conditions in Japan.
银屑病是一种慢性皮肤病,主要影响皮肤、指甲和关节,其特征是炎症。遗传因素促成其发病,环境诱因可加重症状。从病理学角度来看,银屑病的特征是角朊细胞不受控制的增殖和异常分化,组织学特征包括棘层肥厚伴炎症细胞浸润和新生血管形成。银屑病通常始于儿童期,约三分之一的病例在此期间开始。其患病率从 1 岁到 18 岁呈线性增加。患有银屑病的年轻人在儿童和青少年时期,甚至成年后往往需要接受治疗。然而,长期治疗可能会增加并发症和不良事件的风险,因此采用有效治疗方法将这种风险降至最低非常重要。此外,银屑病常与各种合并症相关,这些合并症可能会给儿童的身心健康带来比银屑病本身更大的负担。为了确保良好的长期健康结果,银屑病患者应定期进行筛查。治疗不仅应针对皮肤病变,还应针对任何合并症;然而,目前针对儿童银屑病的治疗方法并没有足够的证据,也没有全球公认的儿童银屑病治疗指南。本文介绍了儿童银屑病的病因、临床表现和疾病负担,斑块状银屑病、银屑病关节炎和泛发性脓疱型银屑病的病理状况和诊断,以及日本对这些疾病的治疗方法。