Abstract：
BACKGROUND: Psoriasis is a papulosquamous condition characterized by type 1 (T1) inflammation, while chronic rhinosinusitis (CRS) concurrent with asthma is commonly a type 2 (T2) process. Since psoriasis is predictive for higher rates of CRS, our objective was to determine whether CRS with concurrent psoriasis would share its T1 pathogenic signature. In comparison to T1 CRS, a T2 process can be predicted by presence of more extensive sinus disease via Lund-MacKay score, reduced sense of smell, and greater concurrence of purulent drainage and pain/pressure.
METHODS: Subjective measurements of CRS included the Sino-Nasal Outcome Test (SNOT-22) and objective measurements included Lund-MacKay sinus CT score and endoscopic scoring. Outcomes were compared with control subjects with CRS co-presenting with allergies, asthma, or aspirin-exacerbated respiratory disease (AERD).
RESULTS: A total of 62 patients (12 CRS alone, 14 CRS/psoriasis, 12 CRS/AERD, 12 CRS/allergic asthmatic, 12 CRS/non-allergic asthmatic) were included. Comparative analysis utilizing χ2 revealed no significant differences in any factor between CRS/psoriatic patients and all other groups associated with T2 presentations. Specifically, psoriatic patients had comparable reductions in smell, similar complaints of pain/pressure, negligible purulent drainage/crusting, and comparable extent of disease on their CT scan, as well as similar blood eosinophilia. The only significant difference was in lack of productivity (p < 0.05) with trends toward reduced concentration, waking up tired, and lack of sleep parameters presumably related to systemic psoriatic manifestations.
CONCLUSIONS: Despite the increased prevalence of CRS in psoriasis patients, our data suggest that when present, psoriasis does not predict the presence of a T1 process in the sinuses.
METHODS: Subjective measurements of CRS included the Sino-Nasal Outcome Test (SNOT-22) and objective measurements included Lund-MacKay sinus CT score and endoscopic scoring. Outcomes were compared with control subjects with CRS co-presenting with allergies, asthma, or aspirin-exacerbated respiratory disease (AERD).
RESULTS: A total of 62 patients (12 CRS alone, 14 CRS/psoriasis, 12 CRS/AERD, 12 CRS/allergic asthmatic, 12 CRS/non-allergic asthmatic) were included. Comparative analysis utilizing χ2 revealed no significant differences in any factor between CRS/psoriatic patients and all other groups associated with T2 presentations. Specifically, psoriatic patients had comparable reductions in smell, similar complaints of pain/pressure, negligible purulent drainage/crusting, and comparable extent of disease on their CT scan, as well as similar blood eosinophilia. The only significant difference was in lack of productivity (p < 0.05) with trends toward reduced concentration, waking up tired, and lack of sleep parameters presumably related to systemic psoriatic manifestations.
CONCLUSIONS: Despite the increased prevalence of CRS in psoriasis patients, our data suggest that when present, psoriasis does not predict the presence of a T1 process in the sinuses.
摘要：
背景：银屑病是一种以1型（T1）炎症为特征的丘疹鳞状疾病，而慢性鼻窦炎（CRS）并发哮喘通常是2型（T2）过程。由于牛皮癣是CRS发病率较高的预测因素，我们的目的是确定CRS并发银屑病是否具有其T1致病特征.与T1CRS相比，T2过程可以通过Lund-MacKay评分通过更广泛的鼻窦疾病的存在来预测，嗅觉减弱,化脓性引流和疼痛/压力的发生率更高。
方法：CRS的主观测量包括鼻窦结果测试（SNOT-22），客观测量包括Lund-MacKay窦CT评分和内窥镜评分。结果与CRS合并过敏的对照组进行比较，哮喘,或阿司匹林加重呼吸道疾病（AERD）。
结果：总共62例患者（仅12例CRS，14CRS/牛皮癣，12CRS/AERD，12CRS/过敏性哮喘，包括12个CRS/非过敏性哮喘）。使用χ2的比较分析显示，CRS/银屑病患者与所有其他与T2表现相关的组之间在任何因素上都没有显着差异。具体来说,牛皮癣患者有相当的嗅觉减少，类似的疼痛/压力抱怨，可忽略的脓性排水/结皮，和他们的CT扫描上的疾病程度相当，以及类似的嗜酸性粒细胞增多。唯一的显着差异是缺乏生产力（p＆lt;0.05）与浓度降低的趋势，醒来累了，和缺乏睡眠参数可能与系统性银屑病表现有关。
结论：尽管银屑病患者的CRS患病率增加，我们的数据表明，当存在时，牛皮癣不能预测鼻窦中T1过程的存在。
方法：CRS的主观测量包括鼻窦结果测试（SNOT-22），客观测量包括Lund-MacKay窦CT评分和内窥镜评分。结果与CRS合并过敏的对照组进行比较，哮喘,或阿司匹林加重呼吸道疾病（AERD）。
结果：总共62例患者（仅12例CRS，14CRS/牛皮癣，12CRS/AERD，12CRS/过敏性哮喘，包括12个CRS/非过敏性哮喘）。使用χ2的比较分析显示，CRS/银屑病患者与所有其他与T2表现相关的组之间在任何因素上都没有显着差异。具体来说,牛皮癣患者有相当的嗅觉减少，类似的疼痛/压力抱怨，可忽略的脓性排水/结皮，和他们的CT扫描上的疾病程度相当，以及类似的嗜酸性粒细胞增多。唯一的显着差异是缺乏生产力（p＆lt;0.05）与浓度降低的趋势，醒来累了，和缺乏睡眠参数可能与系统性银屑病表现有关。
结论：尽管银屑病患者的CRS患病率增加，我们的数据表明，当存在时，牛皮癣不能预测鼻窦中T1过程的存在。
