复旦大学：《皮肤病学 Dermatology》课程教学资源（PPT课件）银屑病相关皮肤病 Psoriasis（英文）

Psoriasis Lianjun Chen Huashan Hospita

Psoriasis Lianjun Chen Huashan Hospital

WHAT IS PSORIASIS? A common, life -long, genetic, autoimmune skin disease Characterized by well circumscribed areas of thick, red, scaly skin From the greek“ soros” meaning"rough scabby? Term first used( along with“ lepra”)by Hippocrates(460-377 B. C )in Corpus Hippocraticum von Hebra first to distinguish psoriasis from leprosy in 1841

WHAT IS PSORIASIS? A common, life-long, genetic, autoimmune skin disease Characterized by well circumscribed areas of thick, red, scaly skin From the Greek “psoros” meaning “rough, scabby” Term first used (along with “lepra”) by Hippocrates (460-377 B.C.) in Corpus Hippocraticum von Hebra first to distinguish psoriasis from leprosy in 1841

Morbidity rate Natural population: 0. 1%03%. Estimated 1.25 hundred million patients in the world China(1984):0.123% a European country: 1. 5%0-3% ■ America:2.6% ■ Hongkong0.3%0(2005

Morbidity rate Natural population: 0.1%~3%. Estimated 1.25 hundred million patients in the world China(1984): 0.123%. ◼ European country: 1.5%-3%. ◼ America: 2.6%. ◼ Hongkong:0.3%(2005 )

Prevalence Equal frequency in males and females May occur at any age from infancy to he 10th decade of life First signs of psoriasis Females mean age of 27 vears Males mean age of 29 years

Prevalence Equal frequency in males and females May occur at any age from infancy to the 10th decade of life First signs of psoriasis – Females mean age of 27 years – Males mean age of 29 years

Prevalence Two Peaks of occurrence One at 20-30 years One at 50-60 years Psoriasis in children Low -between 0.5 and 1.1% in children 16 years old and younger Mean age of onset- between 8 and 12.5 ears

Prevalence Two Peaks of Occurrence – One at 20-30 years – One at 50-60 years Psoriasis in children – Low – between 0.5 and 1.1% in children 16 years old and younger – Mean age of onset - between 8 and 12.5 years

Etiopathogenisis 1. Theory of heredity O Family positive of psoriasis is 4% 11932% in china O Concordance rate in twins monozygotic twins> binovular twins High frequency in HLA-Al, B17, CW6,DR7 a multifactorial inheritance disease

Etiopathogenisis 1.Theory of heredity ⚫ Family positive of psoriasis is 4~91％, 11.9~32% in china ⚫ Concordance rate in twins: monozygotic twins> binovular twins ⚫ High frequency in HLA-A1,B17,Cw6,DR7, a multifactorial inheritance disease

Table 3. Psoriasis susceptibility loci by genome-wide linkage scans Locus Location Reference PSORS1 6p213 Trembath et al. 1997. Nair et al. 1997 Jenisch et al. 1998. Enlund et al, 1999 Balendran et al. 1999. samuelsson et al 1999. oka et al. 1999. Nair et al. 2000 PSORS2 17q24-g25 Tomfohrde et al. 1994. Nair et al. 199 Enlund et al. 1999. samuelsson et al. 1999 PSORS3 4q34 M atthews et al. 1996 PSORS4 1021 Bhalerao and Bowcock 1998, Capon et al 1999 PSORS5 3q21 I Samuelsson et al. 1999, Veal et al.2001 PSORS6 19013 Lee et al. 2000 PSORS7 1p35-p34 Veal et al. 2001 PSORS8 16q12-q13 Nair et al 1997, Karason et al. 2003 D PSORSO 4q31-q32 hang Xuejun, 2002

PSORS9 4q31-q32 zhang Xuejun,2002

Psoriasis, an inherited disease If you have psoriasis, what is the risk to Your unrelated neighbor? About 2% Your sibling? 15-20 Your identical twin? 65-70% n Your child? 25‰-50%

Psoriasis, an inherited disease If you have psoriasis, what is the risk to: Your unrelated neighbor? About 2% Your sibling? 15-20% Your identical twin? 65-70% Your child? 25%-50%

Etiopathogenisis 2.Theory of infection O bacterial infection(esp streptococcus) ● fungal infection bacteria fungI (streptococcus, superantigen)(yeast fungus) lymphocytes activated alternative complement pathway clonal proliferation functional disorder of immune system

Etiopathogenisis 2.Theory of infection ⚫bacterial infection(esp.streptococcus) ⚫fungal infection bacteria fungi (streptococcus、superantigen) (yeast fungus) lymphocytes activated alternative complement pathway clonal proliferation functional disorder of immune system

Etiopathogenisis 3. Abnormal immune function cellular immunity function reduce partly Oearly skin lesions are infiltrated predominantly by lymphocytes Autoantibody deposit in the horny layer OThI/Th2 disequilibrium theory(ThI dominant skin disease)

Etiopathogenisis 3.Abnormal immune function : ⚫cellular immunity function reduce partly ⚫early skin lesions are infiltrated predominantly by lymphocytes ⚫autoantibody deposit in the horny layer ⚫Th1/Th2 disequilibrium theory(Th1 dominant skin disease)