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Komorbiditäten bei Psoriasis vulgaris

Co-morbidities in psoriasis vulgaris

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Zusammenfassung

Epidemiologische Untersuchungen der letzten Jahre dokumentieren nicht nur, dass die Psoriasis häufiger als bisher vermutet mit einer Gelenkbeteiligung einhergeht, sondern dass auch andere Erkrankungen wie Depression, Abhängigkeit, M. Crohn und das metabolische Syndrom mit ihr assoziiert sind. Klinisch ist die daraus resultierende erhöhte kardiovaskuläre Mortalität besonders wichtig und deren pathogenetischer Zusammenhang mit der psoriatischen Entzündung im Sinne einer Komplikation derselben am besten untersucht. Vor diesem Hintergrund ist ein weitreichendes Umdenken im Psoriasismanagement erforderlich: Hautärzten kommt nicht nur die Funktion von Schildwächtern im Rahmen der Früherkennung der Psoriasisarthritis, sondern auch metabolischer Komplikationen wie Fettstoffwechselstörungen und Diabetes zu. Darüber hinaus gilt es, Wechselwirkungen zwischen antipsoriatischer (System-)Therapie und Komedikation unserer Patienten einerseits, aber auch Effekte dieser Komedikation auf den Hautzustand der Patienten andererseits im Auge zu behalten. Um diese Aufgabe effektiv zu bewältigen, sind ein umfassendes Managementkonzept für die Psoriasis und konzeptionell relevante Forschung notwendig.

Abstract

Epidemiologic data document not only a higher prevalence of joint involvement among psoriasis patients than previously thought, but also an association with numerous other diseases, including depression, smoking, alcoholism, Crohn’s disease, and metabolic syndrome. The resulting increased cardiovascular mortality is of particular clinical importance, and its pathogenetic link as a complication of the psoriatic inflammation is well recognized. Thus, we need to re-invent the management of psoriasis: Dermatologists are not only the sentinel regarding the early diagnosis of psoriatic arthritis, but also of metabolic complications such as dyslipidemia or diabetes. Moreover, they need to keep in mind interactions between (systemic) anti-psoriatic drugs and the co-medication of their patients as well as possible consequences of these co-medications on the course of psoriasis. To successfully accomplish this mission, a comprehensive management concept and ground-breaking research are urgently needed.

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin: Referent/Berater folgender Firmen: Abbott, Biogen Idec, Merck Serono, Essex, Wyeth.

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Authors and Affiliations

  1. Zentrum der Dermatologie und Venerologie, Klinikum der Johann Wolfgang Goethe-Universität, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland

    W.-H. Boehncke M.A. & C. Buerger

  2. Medizinsiche Klinik 1, Schwerpunkt Endokrinologie/Diabetologie, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main, Deutschland

    S. Boehncke

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  1. W.-H. Boehncke M.A.
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  2. C. Buerger
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  3. S. Boehncke
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Correspondence to W.-H. Boehncke M.A..

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Boehncke, WH., Buerger, C. & Boehncke, S. Komorbiditäten bei Psoriasis vulgaris. Hautarzt 60, 116–121 (2009). https://doi.org/10.1007/s00105-008-1663-3

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