目的:实验室和临床数据表明神经介导的炎症与银屑病之间存在联系,但银屑病或银屑病关节炎周围神经病变的风险和特征仍不清楚。这项探索性研究的目的是评估银屑病和银屑病关节炎患者周围神经病变的风险并描述其特征。
方法:连续纳入100名银屑病和/或银屑病关节炎患者和100名对照受试者。诊断确认包括电生理检查,皮肤活检,和神经超声检查确诊的多发性神经病。
结果:9例确诊为多发性神经病,而对照组均未出现这种情况(相对风险[RR]=19.00,95%置信区间[CI]=1.12-322.11)。银屑病患者多发性神经病的特定相对风险为22.09(95%CI=1.17-416.43),银屑病关节炎患者为18.75(95%CI=1.07-327.62)。在所有9名患者中观察到的多发性神经病是长度依赖性的,对称,主要是感官,最小或没有残疾。与对照组相比,银屑病和/或银屑病关节炎患者的合并症和暴露于已知会增加多发性神经病风险的疗法更为频繁(42%vs.4%,p=.0001)。在排除可能的促成原因后分析数据,银屑病和/或银屑病关节炎患者的多发性神经病变风险不显著.
结论:银屑病和银屑病关节炎似乎与多发性神经病的风险增加有关。这种增加的风险似乎与多发性神经病的促成因素的患病率较高有关。而不是直接增加与银屑病和银屑病关节炎相关的神经病变风险。
OBJECTIVE: Laboratory and clinical data suggest a link between neurologically mediated inflammation and psoriasis, but the risk and features of peripheral neuropathy in psoriasis or psoriatic arthritis remain unknown. The aim of this exploratory study was to evaluate the risk and to describe the features of peripheral neuropathy in patients with psoriasis and psoriatic arthritis.
METHODS: One hundred patients with psoriasis and/or psoriatic arthritis and 100 control subjects were consecutively enrolled. Diagnostic confirmation included electrophysiological examination, skin biopsy, and nerve ultrasound for confirmed polyneuropathy.
RESULTS: Nine patients were diagnosed with confirmed
polyneuropathy, while none of the control subjects had the condition (relative risk [RR] = 19.00, 95% confidence interval [CI] = 1.12-322.11). Specific relative risks for
polyneuropathy were 22.09 (95% CI = 1.17-416.43) in psoriasis patients and 18.75 (95% CI = 1.07-327.62) in psoriatic arthritis patients. The observed
polyneuropathy in all nine patients was length-dependent, symmetrical, and predominantly sensory, with minimal or no disability. Comorbidities and exposure to therapies known to increase the risk of
polyneuropathy were more frequent in psoriasis and/or psoriatic arthritis patients compared to controls (42% vs. 4%, p = .0001). Analyzing data after excluding possible contributory causes, the risk of
polyneuropathy in patients with psoriasis and/or psoriatic arthritis was not significant.
CONCLUSIONS: Psoriasis and psoriatic arthritis appear to be associated with an increased risk of polyneuropathy. This increased risk seems to be linked to the higher prevalence of contributing factors for polyneuropathy, rather than a direct increase in neuropathy risk specifically related to psoriasis and psoriatic arthritis.