通过全身疗法治疗红皮银病:一个系统性审查
Luca Mastorino1, Francesco Leo2, Giada Frigatti2
1Section of Dermatology, Department of Medical Sciences, University of Turin, Via Cherasco 23, 10126, Turin, Italy. Lucamastorino02@gmail.com.
American journal of clinical dermatology
|August 26, 2025
概括
皮肤上皮 (EP) 治疗包括非生物药物,如甲醇和环素作为第一线治疗方案. 对于严重的病例或治疗失败,生物药物如IL-17抑制剂和risankizumab是有前途的,但证据有限.
科学领域:
- 皮肤病学
- 系统疗法
- 牛皮的研究
背景情况:
- 红皮牛皮 (EP) 是一种严重的,罕见的牛皮变体,带有广泛的红斑和脱落.
- 系统性症状和可能危及生命的并发症需要及时诊断和治疗.
- 目前缺乏针对EP的指导方针和标准化治疗方案.
研究的目的:
- 系统地审查当前的皮肤红斑银病的全身治疗方案.
- 评估各种非生物和生物制剂的疗效和安全性.
主要方法:
- 按照PRISMA指南进行系统审查.
- 在 MEDLINE,PubMed,Scopus 和 Cochrane 图书馆搜索到 2024 年 11 月.
- 包括145项研究,主要是病例报告和系列,有限的随机对照试验.
主要成果:
- 非生物药物甲基和环素的反应率超过了60%;环素为急性治疗提供了更快的效果.
- 在生物药物中,TNF-α抑制剂 (infliximab, certolizumab pegol) 和IL-17抑制剂 (secukinumab) 显示出快速的疗效 (PASI 75> 80%).
- IL-23 抑制剂瑞桑基祖马布的疗效很高 (PASI 90> 75%),但数据有限.
结论:
- 非生物系统性药物是EP的合理第一线治疗方法.
- 对于治疗失败或禁忌,IL-17抑制剂和risankizumab是最受欢迎的生物药物,因为它们具有快速作用和安全性,尽管证据有限.
- 目前的文献具有较低的统计能力,限制了EP治疗疗效的最终结论.
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