Topical therapies for psoriasis: evidence-based review.
Topical therapies for psoriasis: evidence-based review.
复制标题
银屑病的局部治疗：基于证据的审查。
DOI：
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发表时间：
2005
期刊：
影响因子：
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通讯作者：
Youwen Zhou
中科院分区：
文献类型：
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作者：
Tarek M. Afifi;G. D. de Gannes;Changzheng Huang;Youwen Zhou
目的
回顾目前对银屑病局部治疗的认识和方法，并评估其疗效和不良反应。
证据质量
通过MEDLINE检索1987年至2003年（含）的文献，检索词为“银屑病”和“局部治疗”。“文章根据其证据水平进行优先排序，支持双盲，随机对照试验，而不是其他比较研究。其他研究也包括在一级研究不可用的地方。没有列入第三级研究。
主要信息
牛皮癣是非常常见的，并导致大量的发病率。由于大多数银屑病为轻度至中度，因此患者非常适合门诊局部治疗。银屑病局部治疗的进展跟上了对其发病机制的快速发展的理解，对治疗银屑病的现有治疗方法进行了回顾。虽然研究支持继续依赖皮质类固醇作为一线治疗，但维生素D类似物和外用类维生素A的疗效相当，尽管不良反应略有增加。
结论
类固醇和维生素D类似物或外用类维生素A的组合可能是目前最有希望的治疗方法。它似乎有更高的疗效和更少的副作用。
OBJECTIVE
To review current understandings of and approaches to topical psoriasis therapies and to assess their efficacies and adverse effects.
QUALITY OF EVIDENCE
Literature from 1987 to 2003, inclusive, was reviewed via MEDLINE using the search term "psoriasis" combined with "topical treatment." Articles were prioritized based on their level of evidence, favouring double-blind, randomized controlled trials over other comparison studies. Other studies were included where level I research was unavailable. No level III research was included.
MAIN MESSAGE
Psoriasis is very common and causes substantial morbidity. Because most psoriasis is mild to moderate, patients are well suited to outpatient topical therapy. Advances in topical treatments for psoriasis have kept pace with a rapidly evolving comprehension of its pathogenesis, making a review of current therapies useful for those who treat psoriasis. While research supports continued reliance on corticosteroids as first-line therapy, comparable efficacy has been shown for vitamin D analogues and topical retinoids, albeit with a slight increase in adverse effects.
CONCLUSION
The combination of steroids and vitamin D analogues or topical retinoids is perhaps the most promising current treatment. It seems to have increased efficacy and fewer side effects.