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甲银屑病的系统治疗进展

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甲银屑病(nail psoriasis,NP)属于银屑病特殊部位受累,可单独存在,亦可合并其他类型的银屑病,大部分银屑病患者在疾病过程中甲会受到不同程度的影响.由于甲特殊的解剖结构和生理特性,其生长缓慢,局部药物不能有效地穿透甲板,且NP的临床表现多样,治疗疗程长、病情易反复,对患者身心造成不同程度的影响,影响生活质量.虽然银屑病的治疗已经被研究了数十年,但NP属于难治部位,治疗具有挑战性.NP的系统治疗如口服维A酸类药物、甲氨蝶呤、环孢素、阿普米司特、托法替布等,生物制剂如阿达木单抗、乌司奴单抗、依奇珠单抗等,部分药物可有效改善NP,治疗相对安全和有效,显示出其治疗NP良好前景.兹结合近年来国内外文献,就NP的系统治疗进展进行综述.
Advances in systemic treatments of nail psoriasis
Nail psoriasis,a special subtype of psoriasis,can occur independently or concurrently with other subtypes of psoriasis.The nails of the majority of patients with psoriasis are subject to varying degrees of involvement throughout the course of the disease.Due to the special anatomical structure and physiological characteristics of the nails,topical medications cannot penetrate the nail plate effectively.Besides,the nail psoriasis has diverse clinical manifestations and is characterized by a prolonged treatment and frequent relapses,leading to varying degrees of physical and mental impacts on patients,ultimately compromising their quality of life.Despite researches of psoriasis treatment have been conducted for decades,the management of nail psoriasis remains challenging due to its unique anatomical structure.The systemic treatments for nail psoriasis mainly include tretinoin,methotrexate,cyclosporine,apremilast,tofacitinib,and biological agents such as adalimumab,ustekinumab,ixekizumab and others.The administration of certain medications has shown significant efficacy in improving nail psoriasis,while also demonstrating a favorable safety profile,showing a promising prospect for nail psoriasi treatment.In this paper,we will provide a comprehensive review of systemic treatments of nail psoriasis by incorporating relevant literatures from both domestic and international sources.

Psoriasis,nailSystemic treatmentsBiological agents

彭彧婷、陈爱军、王萍

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400016 重庆,重庆医科大学附属第一医院皮肤科

银屑病,甲 系统治疗 生物制剂

国家自然科学基金

82103733

2024

实用皮肤病学杂志
中国人民解放军北京军区总医院

实用皮肤病学杂志

CSTPCD
影响因子:0.637
ISSN:1674-1293
年,卷(期):2024.17(2)