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银屑病关节炎:皮肤科医生综合综述 - 第二部分:筛查与管理

Psoriatic arthritis: A comprehensive review for the dermatologist-Part II: Screening and management.

作者信息

Elman Scott A, Perez-Chada Lourdes M, Armstrong April, Gottlieb Alice B, Merola Joseph F

机构信息

Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida.

Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

出版信息

J Am Acad Dermatol. 2025 May;92(5):985-998. doi: 10.1016/j.jaad.2024.03.059. Epub 2024 Jun 8.

DOI:10.1016/j.jaad.2024.03.059
PMID:38857766
Abstract

Psoriatic arthritis (PsA) is a common comorbidity of psoriasis occurring in up to one-third of patients. Dermatologists hold an essential role in screening patients with psoriasis for PsA, since as many as 85% of patients develop psoriasis before PsA. Early detection and treatment of PsA are important for both short- and long-term patient outcomes and quality of life. Many factors must be weighed when selecting the appropriate therapy for PsA. One must consider the 'domains of disease' that are manifested, the disease severity, patient comorbidities, patient preferences (routes of dosing or frequency, as examples) as well as factors often outside of patient-physician control, such as access to medications based on insurance coverage and formularies. As many patients will have involvement of multiple domains of psoriatic disease, selecting the therapy that best captures the patient's disease is required. In this review, we will address PsA screening, diagnosis, therapeutic approach to psoriatic disease, comorbidity considerations, and comanagement.

摘要

银屑病关节炎(PsA)是银屑病常见的合并症,高达三分之一的银屑病患者会出现该病症。皮肤科医生在筛查银屑病患者是否患有PsA方面起着至关重要的作用,因为多达85%的患者在患PsA之前就已出现银屑病。PsA的早期检测和治疗对于患者的短期和长期预后以及生活质量都很重要。在为PsA选择合适的治疗方法时,必须权衡许多因素。必须考虑所表现出的“疾病领域”、疾病严重程度、患者的合并症、患者的偏好(例如给药途径或频率)以及通常超出医患控制范围的因素,如基于保险覆盖范围和药品目录获取药物的情况。由于许多患者会累及银屑病的多个领域,因此需要选择最能体现患者病情的治疗方法。在本综述中,我们将探讨PsA的筛查、诊断、银屑病疾病的治疗方法、合并症考量以及联合管理。

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