掌跖Pustulosis:危险因素和治疗的系统综述。

IF 5.2 Q1 DERMATOLOGY Psoriasis (Auckland, N.Z.) Pub Date : 2023-09-22 eCollection Date: 2023-01-01 DOI:10.2147/PTT.S400402
Kristine Heidemeyer, Marco May Lee, Simone Cazzaniga, Nikhil Yawalkar, Luigi Naldi
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引用次数: 1

摘要

掌跖脓疱病(PPP)是一种慢性、复发性炎症性疾病,可单独发生或与关节炎相关。是否应将其与银屑病分离或归类为脓疱性银屑病仍存在争议。此外,药物诱导的矛盾PPP是PPP的一种特殊变体,在几个方面与经典PPP不同。PPP的治疗仍然具有挑战性,并且存在许多耐药病例。这篇综述总结了PPP发展的风险因素和目前可用的治疗模式。女性、吸烟者或戒烟者、肥胖、甲状腺功能障碍和肿瘤坏死因子(TNF)-α抑制剂的治疗已被确定为疾病发展、严重程度和病程的风险因素。局部治疗和光疗对一些患者有效,并被用作一线或辅助治疗模式。包括类视黄醇和富马酸在内的常规治疗显示出良好的效果,并且可以提高补骨脂素+紫外线治疗(PUVA)的疗效。环孢素起效快,但复发大多发生在停药后。TNF-α抑制剂是有效的,使用IL-17和IL-23阻断剂以及阿普司特可以获得更好的反应。根据病例报告,Janus激酶抑制剂的效果似乎很有希望,但还需要对更大的队列进行进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Palmoplantar Pustulosis: A Systematic Review of Risk Factors and Therapies.

Palmoplantar pustulosis (PPP) is a chronic, relapsing, inflammatory disease that can occur alone or in association with arthritis. There is still controversy about whether it should be separated from psoriasis or classified as pustular psoriasis. Furthermore, drug-induced paradoxical PPP is a special variant of PPP that differs from classic PPP in several ways. Treatment of PPP is still challenging, and there are a number of treatment-resistant cases. This review summarizes the risk factors for the development of PPP and the currently available treatment modalities. Female sex, smokers or ex-smokers, obesity, thyroid dysfunction, and treatment with a tumor necrosis factor (TNF)-α inhibitor have been identified as risk factors for the disease's development, severity, and course. Topical treatments and phototherapy are effective for some patients and are used as a first-line or adjuvant treatment modality. Conventional treatments including retinoids and fumaric acid show good effects and can increase the efficacy of treatment with psoralen + ultraviolet light therapy (PUVA). Ciclosporin is fast acting, but relapse mostly occurs immediately after cessation. TNF-α inhibitors are efficient, and an even better response can be achieved with IL-17 and IL-23 blockers as well as apremilast. The effect of Janus kinase inhibitors seems to be promising according to case reports, but further investigations with larger cohorts are needed.

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