大家好，我是Laura Savage。我是英国利兹大学的皮肤科顾问医师和高级讲师，也是英国医学皮肤病学会的委员会成员，目前担任银屑病及银屑病关节炎研究与评估小组（GRAPPA）的委员会成员及副主席。
在此次EADV 2025大会上，我们在EADV附近为GRAPPA举办了一场研讨会，我们每年都这样做。年复一年，我们很乐于见到越来越多的皮肤科医生加入GRAPPA。一直以来，我们都很重视风湿疾病，我们十分鼓励世界各地的同仁加入我们，当然，也邀请你们这些中国同仁加入GRAPPA。对于那些不了解GRAPPA的人而言，可以说这是国际临床医生的组织，同时，我们也有友好的研究伙伴，也有非常活跃的年轻GRAPPA部门，从实习生到最资深的顾问，我们都非常欢迎。今年我们在EADV有一个非常多样化的项目。对我自己而言，我谈到了在银屑病患者中管理心理健康的挑战和机遇。谈到了银屑病的发展过程，患者不仅仅是皮肤有问题，还存在系统性的炎症。目前大部分研究工作都集中在心血管共病方面，但我们也需要更多地了解神经炎症及其带来的后果。银屑病控制不佳的患者，在疾病负担、吸烟以及不健康的生活方式等因素的影响下，可能会加重他们的心理健康问题。我们谈论了累积生命历程损伤，以及可以采取哪些策略来预防或减轻它。此外，筛查问卷可以用于识别就诊患者的抑郁和自杀倾向，但这可能存在挑战。临床医生没有很多时间去观察病人，他们害怕打开潘多拉的盒子，他们不知道哪里存在线索，也不知道如何帮助患者，不知道患者是否表现出因银屑病而遭受的严重精神健康损害，或者确实有自杀念头，我们在大约10%的银屑病患者中看到过这种情况。因此，我们探讨了其他的方式。作为皮肤科医生，我们可以通过现有的前沿疗法给患者带去希望，我们需要引导患者根据治疗意见达到良好的疾病控制。我们还讨论了其他一些有用的事情，例如正念疗法和行为认知疗法（CBT），还谈到了一些治疗策略，比如选择性5-羟色胺再摄取抑制剂（SSRI）以及其他可以帮助抑郁症患者的疗法，这确实是皮肤科医生职责的一部分，要为银屑病患者提供全面的管理。
Hello. I'm Dr. Laura Savage. I'm a consultant medical dermatologist and senior lecturer from the University of Leeds in the United Kingdom. I'm also on the board of the British Society of Medical Dermatology and the current vice president of the Group for Research and Assessment in the Psoriasis and Psoriatic Arthritis, also known as GRAPPA.
Here at EADV 2025, we had a symposia for GRAPPA adjacent to the EADV, as we do every year, and it's great to see that year on year, we see more and more dermatologist engaging with GRAPPA. We've always been very rheumatology heavy, so we really are encouraging more worldwide colleagues to join us, and we invite those of you in China, of course, to come and join us in GRAPPA. For those of you not aware about GRAPPA, it says international organizations for clinicians. But we also have patient research partners, and we've got very active young GRAPPA section as well. So trainees through to the most senior consultants, there are absolutely welcome to come and join us. We had a really diverse program here at the EADV this year. So myself, I was speaking about the challenges and opportunities for managing mental health in patients with psoriatic disease. In that we talked about the psoriatic march, and how patients do not just have skin, but they have systemic inflammation. Much of the work has been in looking at cardiovascular comorbidities, but we also need to be more aware about neuro inflammation, and also some of the consequences. That patients with having uncontrolled psoriasis, in terms of things like the burden of disease, smoking and unhealthy lifestyle choices that then can exacerbate their mental health disease. We talked about cumulative life course impairment and how we might employ strategies. We were also talking about screening questionnaires to identify depression and suicidality for patients who were in our clinics, but also how it could be a challenging. Clinicians don't have a lot of time to see patients, and they're fearful of opening pandora's box, and they're not knowing where to sign post or how to help that patient. If they disclose that they have severe mental health impairment from psoriasis, or indeed, suicidal ideation, that we've seen about 10% of patients with psoriasis. So, for that reason, we talked about some other opportunities, but also how we, as the dermatologist, and we can give them hope with the advanced therapies that we have available to them, and how we need to move patients through the therapeutic comment and into have tight disease control. We also covered some of the other things that can be helpful, such as mindfulness and CBT as well, and talked about some of therapeutic strategies in terms of SSRI and another medical therapies that can help patients with depression as well and how it really is part of dermatologist to give holistic management to patients with psoriatic disease.
