Preis S, Ziehfreund S, Biedermann T, Horster S, Zink A
Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany.
Institute for Medical Information Processing, Biometry, and Epidemiology, Pettenkofer School of Public Health LMU Munich, Munich, Germany.
J Eur Acad Dermatol Venereol. 2025 Mar;39(3):512-528. doi: 10.1111/jdv.20256. Epub 2024 Jul 30.
Gender- and sex-specific differences in medicine were long-time disregarded. Despite numerous indications of gender- and sex-specific influences on the treatment of dermatological conditions, these have not yet been systematically investigated.
To meet this unmet need, we conducted the present systematic review on the topic of gender and sex differences in the treatement outcome of skin diseases.
Embase (via Ovid), PubMed Medline and Web of Science were searched, in between January 2001 and December 2022. English and german randomized controlled trials, prospective and retrospective cohorts and case-control studies that examined differences between men and women in treatment outcomes of skin diseases were included.
Two authors independently screened the reports for eligibility, one extracted all data (the second double-checked) and critically appraised the quality and risk of bias of the studies. Eighty-three reports were included. The largest share of the identified publications focused on gender differences in psoriasis and psoriatic arthritis (n = 49), followed by melanoma (n = 8) and sporadic studies (n < 5) of inflammatory, infectious and autoimmune skin diseases. The main topics in which gender differences could be identified were choice of treatment, time to initiation of treatment, therapy response, adverse events, adherence and treatment satisfaction. For psoriasis, gender differences could be found in all aspects, while for the other skin diseases specific publications on gender differences are still missing.
This systematic review shows numerous gender differences but also reveals major gaps in gender-specific care in dermatology which should be narrowed in the upcoming years to optimize a patient-centred, individualized, gender-equal healthcare. PROSPERO Registration: CRD42022306626.
医学中性别和性别的特异性差异长期以来一直被忽视。尽管有大量迹象表明性别特异性对皮肤病治疗有影响，但尚未对其进行系统研究。
为满足这一未被满足的需求，我们对皮肤病治疗结果中的性别差异这一主题进行了本次系统评价。
检索了2001年1月至2022年12月期间的Embase（通过Ovid）、PubMed Medline和Web of Science。纳入了英语和德语的随机对照试验、前瞻性和回顾性队列研究以及病例对照研究，这些研究探讨了男性和女性在皮肤病治疗结果方面的差异。
两位作者独立筛选报告的合格性，一位提取所有数据（另一位进行二次核对）并严格评估研究的质量和偏倚风险。共纳入83篇报告。已识别出版物中最大比例聚焦于银屑病和银屑病关节炎的性别差异（n = 49），其次是黑色素瘤（n = 8）以及关于炎症性、感染性和自身免疫性皮肤病的零星研究（n < 5）。能够识别出性别差异的主要主题包括治疗选择、开始治疗的时间、治疗反应、不良事件、依从性和治疗满意度。对于银屑病，在各个方面都能发现性别差异，而对于其他皮肤病，关于性别差异的具体出版物仍然缺失。
本系统评价显示了众多性别差异，但也揭示了皮肤科性别特异性护理方面的重大差距，未来几年应缩小这些差距，以优化以患者为中心、个性化、性别平等的医疗保健。PROSPERO注册号：CRD42022306626。
