我是Peter van de Kerkhof。我是荷兰拉德堡德大学奈梅亨医学中心的皮肤病学教授、专业的皮肤科培训师。作为部门主席，我负责学术研究和患者诊疗以及其他方面。我们对银屑病、炎症性皮肤病以及角化异常特别感兴趣。今天，我参加了在巴黎举行的2025年欧洲皮肤病与性病学会大会（EADV 2025）。我期待回答与EADV 2025相关的问题。
本次大会上有哪些关于银屑病的突破性进展？
本次大会上有很多重要突破，我很想谈谈这些突破。首先，一个巨大且重要的突破是对炎症性皮肤病新疗法的研究。过去，我们在银屑病治疗方面取得了重大突破。
现在，不仅仅是银屑病，还包括特应性皮炎、化脓性汗腺炎、白癜风、痒疹和斑秃。我们注意到，在炎症性皮肤病的许多领域，治疗方法正在发生改变。我们真的非常乐于在本期特辑中重点介绍这些变化。新疗法在欧洲得到了很好的使用。生物制剂仿制药的生产大大降低了专利生物制剂的价格。然后是炎症性皮肤病的重要评分系统。我们不仅可以通过肉眼观察银屑病、斑秃或白癜风的改善情况，还能够更准确地量化这种改善。然后是有关于毛发疾病的重要报道。5年前，斑秃还是一种难以治疗的疾病。我们现在看到，借助Janus激酶抑制剂这类小分子药物，我们正迎来巨大且重要的新机遇。在肿瘤学领域，这也是重要的变化。
此外，我还想谈谈HIV和皮肤病学中的细胞疗法。关于HIV阳性患者皮肤表现的精彩报告，一个重要的新方向是免疫代谢学。在许多炎症性皮肤病中，免疫学一直很重要。如今，免疫学与代谢性疾病的关系已有了相关的科学依据。这也为新的治疗方法开辟了新的途径。比如GLP-1激动剂、关注生活方式、减重。所有人都可以这么做，减重是易于执行的，但部分患者可能会面临困难，但它对许多炎症性皮肤病合并症的严重程度有着巨大且重要的影响。作为皮肤科医生，我们不只是关注皮肤。除了精通于皮肤领域，我们在皮肤病合并症方面也有专长，例如银屑病、银屑病关节炎、代谢综合征。上述议题在EADV大会上均有所呈现。本次特辑将汇总众多创新成果。
根据大会和特辑的共识，银屑病（特别是合并症管理）的教育重点应如何发展？下一代皮肤科医生应该从本期内容中获得哪些关键知识和思维方式，以应对该领域日益复杂的问题？
首先，我想在此强调的是：不是只有银屑病需要早期干预，而是所有炎症性皮肤病都需要早期干预。皮肤炎症的持续时间越长，治疗就越难以奏效，这与部分记忆细胞有关。它们长期驻留在皮肤中，导致炎症迁延不愈。因此，在炎症性皮肤病中，早期积极干预是很重要的。这是其中一方面，另一方面是我们在皮肤病领域的目标。我们没有非常有效的靶向治疗方法，并不是说我们应该满足于最小幅度的改善，我们应该追求最大的改善。最理想的改善是皮损几乎完全清除或完全清除，这是我们在皮肤病领域的目标，以及可持续的疗法。我们应该争取对皮肤病的长期控制，这是我们真正的目标所在。因此，我们正朝着更有效地干预皮肤病的方向前进，这远远超过改善皮肤病本身。我们的目标不只是皮肤表面。
My name is Peter van de Kerkhof.I'm a professor of Dermatology at the Radboud University Nijmegen Medical Centre.I have been a trainer in dermatology, a specialist trainer.I've been the chair of the department, research and patient care,and various aspects. We have a special interest in psoriasis, inflammatory skin disease, disorders of keratinization. Today, I am at the EADV 2025 in Paris. I'm really looking forward to answering some questions related to the EADV 2025.
Which breakthrough advances in psoriasis from this congress?
This Congress has important breakthroughs, which I really would like to speak about. Firstly, an enormous, important breakthrough is the new treatments for inflammatory skin disease studies. In the past, we had important breakthroughs through the treatment of psoriasis. But now it's not only psoriasis. It's also atopic dermatitis. It is hidradenitis suppurativa, vitiligo. It's prurigo, alopecia areata. We see that in many areas of inflammatory diseases of the skin, the treatment is changing. We are ever so happy indeed, in this special program to highlight these changes. There is also good use here in Europe, with the production of biosimilars for biological therapy, which has reduced price enormously for the proprietary biologics. Then important scoring systems for inflammatory skin diseases that we just not look with the naked eye how psoriasis, alopecia areata or vitiligo is improving, but actually we are now able to calculate better the improvement that do quantify actually the improvement. Then there are important reports on hair diseases. Alopecia areata, until five years ago, was a condition very difficult to treat. We see now that with Janus kinase inhibitors, with small molecules, that there are enormous, important new opportunities. But also in oncology, that are important changes. And I would like also to mention cell therapy in HIV and dermatology. Nice presentations of skin manifestations in HIV positive patients, And an important new direction is immunometabolism. Immunology has been always important in many inflammatory skin diseases, but the connection to metabolic diseases now gets its scientific basis, and that also opens new avenues for new treatments, like the GLP-1 agonists, attention for lifestyles, weight loss, which can be done all over the world. Weight Loss is so simple, it seems difficult sometimes for the patient, but it has enormous and important implications for the extent of many inflammatory skin diseases comorbidities. We as dermatologists, are not only doctors for the skin. We are doctors, of course, with an expertise in skin, but also in commobilities of skin diseases, For example, in psoriasis, psoriatic arthritis, metabolic syndrome. And all these aspects are here at EADV, and the program will summarize many innovations.
Based on consensus from the congress and the Special Edition, how should educational focus in psoriasis (especially comorbidity management) evolve? What key knowledge and mindset should next-generation dermatologists gain from this edition to tackle growing complexities in the field?
Firstly, I would like to call here early intervention, not only in psoriasis, but also in inflammatory skin diseases. The longer that an inflammation exists in the skin, the more resistant for treatments it will be. That has to be explained with some memory cells, which stay in the skin and explain actually long term inflammation. So, in inflammatory skin diseases, early active intervention is important. So that's one thing. And the other aspect is ambition in dermatology. We have no targeted treatments which are highly effective. And is not that we should satisfy ourselves with a minimal improvement. We should go for optimal improvement. And optimal improvement is nearly clear skin or clear skin. So ambition in dermatology, and then sustainable treatments. We should strive for long term control of skin diseases. That is actually what our ambition should be. So, we are moving in the direction of a more potent interference with skin diseases and a much more improvement than only the skin itself. We go for more than skin deep.
