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Komorbiditäten und Psoriasis

Konsequenzen für die Praxis

Comorbidities and psoriasis

Impact on clinical practice

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Zusammenfassung

Psoriasis ist eine genetisch determinierte, chronisch entzündliche Systemerkrankung. Neben charakteristischen Hautmanifestationen treten insbesondere bei mittelschwer bis schwer betroffenen Patienten andere Erkrankungen gehäuft auf. Diese begleitend auftretenden Erkrankungen werden als Komorbiditäten bezeichnet. Metabolische Erkrankungen (wie z. B. Diabetes mellitus, Insulinresistenz, Fettstoffwechselstörungen, meist auf der Grundlage einer Adipositas) und kardiovaskuläre Erkrankungen (wie z. B. arterieller Hypertonus, koronare Herzkrankheit, Myokardinfarkt und Apoplex) sind dabei von besonderer Bedeutung, da sie auch die Mortalität der Patienten beeinflussen können. Aber auch psychiatrische Erkrankungen sind bei Psoriasispatienten häufig und beeinflussen das Therapiemanagement. Der Dermatologe ist in den meisten Fällen der erste Ansprechpartner von Psoriasispatienten und somit die Schlüsselfigur im Therapiemanagement. Er ist dabei auch für die Früherkennung und Therapiesteuerung von Komorbiditäten mitverantwortlich. Die von ihm durchgeführte antipsoriatische Therapie muss mit den vorliegenden Komorbiditäten und deren medikamentösen Therapien abgestimmt werden. Der folgende Beitrag stellt den aktuellen Wissensstand über die psoriatischen Komorbiditäten und ihre Konsequenzen für die Praxis dar.

Abstract

Psoriasis is a genetically determined, chronic inflammatory systemic disease. Besides skin symptoms, patients with moderate to severe forms of psoriasis show an association with other diseases, referred to as comorbidities. Metabolic disorders (e.g. diabetes mellitus, insulin resistance, dyslipidemia mainly in obese patients) and cardiovascular diseases (e.g. arterial hypertension, coronary artery disease, myocardial infarction and stroke) are of importance as they can increase patients’ mortality. In addition, psychiatric diseases are more frequent in psoriasis patients and influence the therapeutic approach. The dermatologist in most cases is the primarily consulted physician for patients with psoriasis and therefore plays the role as a gatekeeper managing therapy. He is responsible for the early diagnosis of comorbidities and insuring their appropriate management. The anti-psoriatic treatment has to be adapted to existing comorbidities and their systemic treatments. The following article provides information on psoriatic comorbidities and their consequences for daily practice.

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  1. Psoriasis-Zentrum an der Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Schittenhelmstr. 7, 24105, Kiel, Deutschland

    S. Gerdes & U. Mrowietz

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Gerdes, S., Mrowietz, U. Komorbiditäten und Psoriasis. Hautarzt 63, 202–213 (2012). https://doi.org/10.1007/s00105-011-2230-x

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