Title (croatian) Psorijaza – vidljivi ubojica
Title (english) Psoriasis – visible killer
Author Dora Gašparini https://orcid.org/0000-0002-0503-9516 Medicinski fakultet, Sveučilište u Rijeci, Rijeka
Author Marija Kaštelan Katedra za dermatovenerologiju, Medicinski fakultet, Sveučilište u Rijeci, KBC Rijeka, Rijeka, Hrvatska
Author's institution University of Rijeka Faculty of Medicine (Department of Dermatovenerology)
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Dermatovenerology
Abstract (croatian) Psorijaza je jedna od najčešćih kroničnih kožnih bolesti s prevalencijom od 1,6 – 3 % u općoj populaciji, stoga je ta bolest vrlo važan javnozdravstveni problem. Riječ je o upalnom imunosno posredovanom poremećaju koji se na koži očituje eritematoskvamoznim plakovima na predilekcijskim mjestima. Psorijaza nije životno ugrožavajuća bolest, ali kardiovaskularni rizični čimbenici povezani s njom mogu dovesti do letalnog ishoda. Metabolički sindrom češće se dijagnosticira u pacijenata sa psorijazom u odnosu na opću populaciju, i to ponajviše u pacijentica starijih od 40 godina koje dugo boluju od teškog oblika bolesti. Etiologija razvoja metaboličkih poremećaja nije još u potpunosti razjašnjena, ali postoje dokazi da metaboličke promjene nisu isključivo posljedica dugotrajno aktivne kožne bolesti, već da i prethode prvoj pojavi bolesti. Imunosni odgovor posredovan T-pomoćničkim (engl. T helper, Th) Th1 i Th17 limfocitima sustavno prisutan u pacijenata sa psorijazom pridonosi razvoju ili pogoršanju šećerne bolesti, arterijske hipertenzije i pretilosti. Terapija psorijaze temelji se na liječenju kožne bolesti i komorbiditeta, a prilagođena je pojedinom pacijentu. Primjena metotreksata i bioloških lijekova poput infliksimaba, adalimumaba i etanercepta povezana je s nižim stopama mortaliteta, infarkta miokarda i moždanog udara te s poboljšanjem endotelne funkcije u odnosu na pacijente liječene drugim terapijskim mogućnostima. Pristup pacijentu sa psorijazom mora biti sveobuhvatan i multidisciplinaran te uključivati liječenje psorijaze uz prevenciju, rano prepoznavanje i odgovarajuće liječenje komorbiditeta.
Abstract (english) Psoriasis is one of the most common chronic skin diseases with the prevalence of 1.6-3% in general population, therefore it is an important public health issue. It is an inflammatory immunomediated disorder that manifests as a eritematosquamous dermatosis with plaques on predilection areas. Psoriasis is not a life-threatening disease itself, however cardiovascular risk factors connected to it may lead to a lethal outcome. Metabolic syndrome is diagnosed in patients with psoriasis more often than in general population, especially in female patients older than 40 years old with a longer and more severe form of psoriasis. Etiology of the metabolic changes is still not completely understood, although there is evidence that metabolic changes are not exclusively the result of long active disease, but can precede the first onset of symptoms. T helper (Th) Th1- and Th17-cells-mediated immunological response systemically present in psoriasis contributes to the development or deterioration of diabetes mellitus, high blood pressure and obesity. Treatment of psoriasis is based on the management of skin disease and its comorbidities adjusted to individual patient. Use of methotrexate and biological agents such as infliximab, adalimumab and etanercept has shown lower rates of mortality, myocardial infarction and stroke with improvement of endothelial function in regards to patients treated with other therapeutical options. Approach to a patient suffering from psoriasis needs to be comprehensive and multidisciplinary, involving the management of psoriasis, prevention, early diagnosis and adequate management of its comorbidities.
Keywords (croatian)
kardiovaskularne bolesti
komorbiditet
psorijaza
terapija
Keywords (english)
cardiovascular diseases
comorbidity
psoriasis
therapeutics
Language croatian
Language english
Publication type Scientific paper - Review paper
Publication status Published
Peer review Peer review
Publication version Published version
Journal title Medicina Fluminensis : Medicina Fluminensis
Numbering vol. 55, no. 3, pp. 215-223
p-ISSN 1847-6864
e-ISSN 1848-820X
DOI https://doi.org/10.21860/medflum2019_221607
URN:NBN urn:nbn:hr:184:931008
Publication 2019
Document URL https://hrcak.srce.hr/221607
Type of resource Text
Access conditions Open access
Terms of use
Created on 2019-09-09 12:46:26