Sarcoidosis and Psoriasis A Case Series and Review of the Literature Exploring Co-Incidence vs Coincidence
Sarcoidosis and Psoriasis A Case Series and Review of the Literature Exploring Co-Incidence vs Coincidence
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DOI：
10.1001/jamadermatol.2013.4256
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发表时间：
2013-07-01
期刊：
影响因子：
10.9
通讯作者：
Rosenbach, Misha
中科院分区：
文献类型：
--
作者：
Wanat, Karolyn A.;Schaffer, Andras;Rosenbach, Misha
重要性 结节病是一种慢性多系统疾病，其特征是形成影响多个器官系统的非干酪样上皮样细胞肉芽肿。 1 型辅助 T (T(H)1) 细胞在结节肉芽肿形成中的作用已得到充分证明，结节病中的 T(H)17 通路目前正在研究中。已知 T(H)17 细胞也参与银屑病的发病机制，并且基于潜在的共同基础免疫通路，结节病和银屑病共存在机制上是合理的。 观察 我们报告了 7 名结节病和寻常型银屑病患者的病例系列。所有患者均患有牛皮癣，病情范围从局限性到累及体表面积的 30%，并有肺结节病的证据。其中 3 名患者还患有皮肤结节病，其中 1 名患者在同一皮肤标本中具有银屑病和结节病的证据。结论和相关性我们报告了并发结节病和银屑病的病例系列，表明涉及 T(H)1 和 T(H)17 途径的共同发病机制可能是造成这种疾病关联的原因。尽管需要更多数据来阐明这种关联，但这一观察结果可能会导致对这些疾病的病理生理学和治疗管理的重要理解。
IMPORTANCE Sarcoidosis is a chronic multisystem disorder characterized by the formation of noncaseating epithelioid cell granulomas affecting multiple organ systems. The role of the type 1 helper T (T(H)1) cell in sarcoidal granuloma formation has been well documented, and the T(H)17 pathway in sarcoidosis is just now being investigated. T(H)17 cells are also known to involved in the pathogenesis of psoriasis, and the coexistence of sarcoidosis and psoriasis is mechanistically plausible based on potential shared underlying immunologic pathways.OBSERVATIONS We report a case series of 7 patients with sarcoidosis and psoriasis vulgaris. All patients had psoriasis ranging from limited disease to involvement of 30% of their body surface area and had evidence of pulmonary sarcoidosis. Three of these patients also had cutaneous sarcoidosis, and 1 of these patients had evidence of both psoriasis and sarcoidosis in the same cutaneous specimen.CONCLUSIONS AND RELEVANCE We report a case series of concomitant sarcoidosis and psoriasis, suggesting that common pathogenesis involving the T(H)1 and T(H)17 pathways may be responsible for this disease association. Although additional data are needed to clarify this association, this observation may lead to important understanding of the pathophysiologic and therapeutic management in these disorders.