Arango Sebastian, Aoki Kawaiola Cael, Huq Shakil O, Blanca Alexander, Kesselman Marc M
Medical School, Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Davie, USA.
Rheumatology, Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Davie, USA.
Cureus. 2024 Nov 18;16(11):e73929. doi: 10.7759/cureus.73929. eCollection 2024 Nov.
Psoriasis (PsO) is a chronic, systemic, and autoimmune dermatologic condition characterized by dry, scaly, and erythematous plaques on the skin. PsO can present in various forms, including guttate (small, round lesions commonly over the upper trunk and extremities that can be raised and scaly), inverse (smooth plaques of inflamed skin within skin folds of the groin, buttock, and breasts), pustular (white painful pustules within red inflamed blotches widespread over the body), and erythrodermic (red rash present over most of the body). Individuals with PsO can present differently, with unique symptoms and patterns on the skin. These diverse manifestations make PsO a complex condition with mild to severe symptoms affecting different body areas. Researchers have identified intrinsic risk factors (and comorbidities) tied to PsO, including genetics, obesity, metabolic syndrome, infection, cardiovascular disease, stress, and type 2 diabetes mellitus (T2DM). In addition, several extrinsic risk factors have also been shown to be tied to PsO onset and progression, such as ultraviolet (UV) light, air pollution, and various pharmacological treatments. While these intrinsic and extrinsic factors have been tied to disease pathophysiology, the underlying mechanisms of disease activity have yet to be elucidated fully, making diagnosis and treatment cumbersome. Currently, PsO is diagnosed clinically with no definitive test. Noninvasive tools such as dermoscopy aid in diagnosis, while the biopsy is reserved for difficult-to-characterize psoriatic-like lesions. The reliance on clinical presentation and the lack of diagnostic testing available have led to the underdiagnosis of PsO, particularly in minority communities. The goal of this study is to utilize data from the National Health and Nutrition Examination Survey (NHANES) to improve the diagnosis of PsO and target treatment more effectively, and biometric measurements associated with PsO should be studied to aid clinical practitioners in better understanding the disease pathophysiology and improve patient diagnosis, management, and prognosis. Using the dataset, we conducted a retrospective cohort study to find which variables are significantly associated with PsO. These objective measurements can complement clinical assessments by providing quantifiable data that could improve accuracy by detecting PsO in its early stages or distinguishing it from other skin conditions with similar presentations. This enables healthcare providers to adjust management strategies based on measurable changes in disease markers, rather than relying solely on subjective clinical observations.
银屑病(PsO)是一种慢性、全身性自身免疫性皮肤病,其特征为皮肤出现干燥、鳞屑状和红斑性斑块。PsO可呈现多种形式,包括点滴状(通常出现在上躯干和四肢的小圆形皮损,可隆起且有鳞屑)、反向性(腹股沟、臀部和乳房皮肤褶皱内的光滑炎症性斑块)、脓疱性(遍布全身的红色炎症斑内的白色疼痛脓疱)和红皮病型(身体大部分区域出现的红色皮疹)。PsO患者的表现可能不同,皮肤上有独特的症状和形态。这些多样的表现使PsO成为一种复杂的疾病,症状从轻度到重度,影响不同身体部位。研究人员已确定与PsO相关的内在风险因素(和合并症),包括遗传、肥胖、代谢综合征、感染、心血管疾病、压力和2型糖尿病(T2DM)。此外,一些外在风险因素也被证明与PsO的发病和进展有关,如紫外线(UV)、空气污染和各种药物治疗。虽然这些内在和外在因素与疾病病理生理学相关,但疾病活动的潜在机制尚未完全阐明,这使得诊断和治疗变得繁琐。目前,PsO主要通过临床诊断,没有确定性检测方法。皮肤镜等非侵入性工具有助于诊断,而活检则用于难以定性的银屑病样皮损。对临床表现的依赖以及缺乏可用的诊断检测导致PsO诊断不足,尤其是在少数族裔社区。本研究的目的是利用国家健康和营养检查调查(NHANES)的数据改善PsO的诊断并更有效地靶向治疗,并且应研究与PsO相关的生物特征测量,以帮助临床医生更好地理解疾病病理生理学,改善患者诊断、管理和预后。利用该数据集,我们进行了一项回顾性队列研究,以确定哪些变量与PsO显著相关。这些客观测量可以通过提供可量化数据来补充临床评估,这些数据可以通过在早期检测PsO或区分它与其他有相似表现的皮肤疾病来提高准确性。这使医疗保健提供者能够根据疾病标志物的可测量变化调整管理策略,而不是仅仅依赖主观临床观察。