Actas dermo-sifiliograficas最新文献

英文中文

Mortality outcomes in patients with plaque psoriasis and hidradenitis suppurativa: the role of biologic therapy. 斑块型银屑病和化脓性汗腺炎患者的死亡率：生物治疗的作用。

IF 2.8 Q1 DERMATOLOGY

Actas dermo-sifiliograficas

Pub Date : 2025-12-04 DOI: 10.1016/j.ad.2025.104525

R Rivera-Díaz, B Joven, A Gotor-Rivera, J Hernández

Background and objectives: Plaque psoriasis (Pso) and hidradenitis suppurativa (HS) are chronic inflammatory diseases associated with multiple comorbidities, including cardiovascular conditions, which may negatively impact survival. The aim of this study was to analyze mortality in patients with Pso and HS vs the general population and to each other, as well as the potential impact of biologic therapy on mortality.

Materials and methods: We conducted a retrospective cohort study based on electronic health records retrieved from the TriNetX platform. Patients diagnosed with Pso or HS, with or without biologic therapy, were compared with matched cohorts from the general population and with each other. Cohorts were matched using propensity score matching (PSM) and adjusted for age, sex, and comorbidities potentially affecting mortality, including smoking, diabetes, hyperlipidemia, hypertension, overweight and obesity, cardiovascular disease, pulmonary embolism, venous thrombosis, ischemic heart disease, and cerebrovascular disease. The mortality incidence rate was assessed using risk ratio (RR) and hazard ratio (HR), with 95% confidence intervals (CIs) during a 10-year follow-up.

Results: After adjustment, 76.191 patients with Pso and 52.354 with HS were included. Compared to the general population, patients with Pso showed a higher mortality risk (RR, 2.25; 95%CI, 2.18-2.32; HR, 2.02; 95%CI, 1.95-2.08), with a significant reduction in those treated with biologics (RR, 0.76; 95%CI, 0.70-0.83; HR, 0.62; 95%CI, 0.57-0.67). Similarly, patients with HS also exhibited a higher mortality risk (RR, 2.25; 95%CI, 2.14-2.37; HR, 2.28; 95%CI, 2.16-2.40), which was attenuated in those treated with biologics (RR, 0.80; 95%CI, 0.65-0.99; HR, 0.62; 95%CI, 0.49-0.77). When comparing both diseases, patients with HS had a higher mortality risk vs those with Pso (HR, 1.16; 95%CI, 1.11-1.22). The same trend was observed in biologic-treated subgroups (RR, 1.30; 95%CI, 1.00-1.68; HR, 1.45; 95%CI, 1.12-1.90).

Conclusions: both psoriasis (pso) and hidradenitis suppurativa (hs) are associated with an increased risk of mortality, which appears to be mitigated by biologic therapy. Early and comprehensive management of these conditions, including systemic inflammation control and comorbidity screening, may improve survival outcomes.

背景和目的：斑块型银屑病（Pso）和化脓性汗腺炎（HS）是慢性炎症性疾病，伴有多种合并症，包括心血管疾病，可能对生存产生负面影响。本研究的目的是分析Pso和HS患者与一般人群的死亡率，以及相互之间的死亡率，以及生物治疗对死亡率的潜在影响。材料和方法：我们基于从TriNetX平台检索的电子健康记录进行了一项回顾性队列研究。诊断为Pso或HS的患者，接受或不接受生物治疗，与来自一般人群的匹配队列进行比较，并相互比较。使用倾向评分匹配（PSM）对队列进行匹配，并根据年龄、性别和可能影响死亡率的合并症进行调整，包括吸烟、糖尿病、高脂血症、高血压、超重和肥胖、心血管疾病、肺栓塞、静脉血栓形成、缺血性心脏病和脑血管疾病。在10年随访期间，采用风险比（RR）和危险比（HR）评估死亡率，95%置信区间（ci）。结果：经调整后，共纳入Pso患者76.191例，HS患者52.354例。与一般人群相比，Pso患者的死亡风险较高（RR, 2.25; 95%CI, 2.18-2.32； HR, 2.02; 95%CI, 1.95-2.08），而接受生物制剂治疗的患者死亡率显著降低（RR, 0.76; 95%CI, 0.70-0.83； HR, 0.62; 95%CI, 0.57-0.67）。同样，HS患者也表现出较高的死亡风险（RR, 2.25; 95%CI, 2.14-2.37； HR, 2.28; 95%CI, 2.16-2.40），而接受生物制剂治疗的患者死亡率降低（RR, 0.80; 95%CI, 0.65-0.99； HR, 0.62; 95%CI, 0.49-0.77）。当比较两种疾病时，HS患者的死亡风险高于Pso患者（HR, 1.16; 95%CI, 1.11-1.22）。在生物处理亚组中观察到同样的趋势（RR, 1.30; 95%CI, 1.00-1.68； HR, 1.45; 95%CI, 1.12-1.90）。结论：银屑病（pso）和化脓性汗腺炎（hs）都与死亡风险增加相关，生物治疗似乎可以减轻这种风险。对这些疾病进行早期和全面的管理，包括全身性炎症控制和合并症筛查，可能会改善生存结果。

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Actas dermo-sifiliograficas

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IF 2.8 Q1 DERMATOLOGY

Actas dermo-sifiliograficas

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IF 2.8 Q1 DERMATOLOGY

Actas dermo-sifiliograficas

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In the routine clinical practice in dermatology, there is a high burden of psychiatric morbidity due to primary psychiatric disorders that secondarily affect the skin or dermatological disorders that secondarily can have a profound psychosocial and mental health impact. We present a narrative review on the use of psychotropic drugs, with the aim of addressing the intersection between mental health and dermatology. The article aims to be a practical guide, providing clear and concise recommendations on the indications, dosing, adverse effects, special considerations, or contraindications of the most widely used drugs today, with the goal of providing dermatologists with the basic tools for the appropriate global therapeutic management of these patients.

在皮肤科的常规临床实践中，由于继发影响皮肤的原发性精神疾病或继发影响社会心理和精神健康的皮肤病，精神疾病发病率的负担很高。我们提出了一个叙述性的审查使用精神药物，以解决精神健康和皮肤病学之间的交集的目的。本文旨在成为一个实用指南，就当今最广泛使用的药物的适应症、剂量、不良反应、特殊注意事项或禁忌症提供清晰简明的建议，目的是为皮肤科医生提供适当的全球治疗管理这些患者的基本工具。

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IF 2.8 Q1 DERMATOLOGY

Actas dermo-sifiliograficas

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IF 2.8 Q1 DERMATOLOGY

Actas dermo-sifiliograficas

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IF 2.8 Q1 DERMATOLOGY

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IF 2.8 Q1 DERMATOLOGY

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Identification of a novel heterozygous variant c.497g>a (p.gly166glu) in exon 5 of the sting1 gene as the causative factor of sting-associated vasculopathy with onset in infancy (SAVI): a case report. 鉴定sting基因5外显子c.497g>a （p.gly166glu）是婴儿期发病的蜇伤相关血管病变（SAVI）的致病因素：一个病例报告。

IF 2.8 Q1 DERMATOLOGY

Actas dermo-sifiliograficas

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