Psoriasis phenotype at disease onset:: Clinical characterization of 400 adult cases
Psoriasis phenotype at disease onset:: Clinical characterization of 400 adult cases
复制标题
DOI：
10.1111/j.0022-202x.2004.23611.x
复制
发表时间：
2005-03-01
影响因子：
6.5
通讯作者：
Ståhle, M
中科院分区：
文献类型：
--
作者：
Mallbris, L;Larsson, P;Ståhle, M
银屑病在临床上是一种异质性疾病。缺乏对疾病发作时表型的详细评估。这项研究是对400名首次在无毛皮肤上发生银屑病的成年个体的基线表征，描述了疾病发作时的临床表型和推定的环境触发因素。总共纳入了74名点滴表型患者和326名非点滴表型患者，其中大多数患有斑块状银屑病。滴状表型与84%的患者年龄较小和近期感染相关，其中63%的患者证实为急性链球菌性咽炎。与斑块状银屑病发病相关的主要因素是近期的生活危机（46%）。银屑病阳性家族史在两组中大致相同。在5%的点滴患者和15%的非点滴患者中诊断出银屑病关节病，其中末端病是点滴患者的主要症状。这项研究证实了滴状银屑病表型和链球菌咽喉感染之间的密切联系，而斑块状银屑病的发病与先前的明显压力生活事件高度相关。对患者的纵向随访将提供关于疾病发展和对治疗的反应的可靠信息。
Psoriasis is clinically a heterogeneous disease. Detailed evaluation of phenotype at disease onset is lacking. This study is a baseline characterization of 400 adult individuals with first time incidence of psoriasis on non-hairy skin, describing clinical phenotypes and putative environmental triggers at disease onset. In total, 74 patients with guttate and 326 patients with non-guttate phenotype, the majority with plaque psoriasis, were included. Guttate phenotype was associated with younger age and recent infection in 84%, where acute streptococcal pharyngitis was verified in 63%. The predominating factor associated with onset of plaque psoriasis was a recent life crisis (46%). A positive family history for psoriasis was approximately the same in both groups. Psoriasis arthropathy was diagnosed in 5% of guttate and 15% of non-guttate patients, with enthesopathy being the dominant symptom among guttate patients. This study confirms the strong link between onset of guttate psoriasis phenotype and streptococcal throat infection, whereas onset of plaque psoriasis was highly associated with a preceding distinct stressful life event. Longitudinal follow-up of the patients will provide robust information about disease development and response to treatment.