EADV 2025｜银屑病关节炎的早期识别与干预

在本次学术对话中，意大利维罗纳大学的Paolo Gisondi教授与浙江大学附属第二医院的周园博士，就银屑病关节炎的早期识别与干预策略进行了深入交流。

Gisondi教授指出，银屑病是发展为银屑病关节炎的主要风险因素，皮肤科医生因此在早期识别中处于关键位置。他强调，在疾病前驱期或临床前期，识别临床症状至关重要。教授开发了简便实用的PsA筛查问卷，并指出皮肤疾病严重程度、肥胖、指甲受累及阳性家族史是重要的风险因素。其中，皮肤严重程度、肥胖和指甲受累是可干预的因素，有效治疗皮肤和指甲、促进患者减重，均有助于降低PsA发生风险。

周园博士分享了其团队在《JCI》上发表的最新研究成果，揭示了皮肤炎症与关节炎症之间存在相互作用，并发现CCL-8可能作为预测PsA发展的潜在生物标志物。她提出设想，对于无症状但生物标志物升高的高风险银屑病患者，在极早期阶段使用JAK抑制剂或生物制剂进行干预，或可带来获益。

双方一致认为，寻找客观生物标志物与重视患者临床症状（尤其是关节疼痛）同样重要。这场对话凸显了皮肤科医生在PsA早期管理中的核心作用，以及基础研究与临床实践紧密结合推动诊疗进步的广阔前景。

In this scientific dialogue, Professor Paolo Gisondi from the University of Verona, Italy, and Dr. Zhou Yuan from the Second Affiliated Hospital of Zhejiang University, held an in-depth discussion on the early recognition and intervention strategies for Psoriatic Arthritis (PsA).

Professor Gisondi emphasized that psoriasis is a major risk factor for developing PsA, placing dermatologists in a pivotal position for early detection. He stressed the importance of recognizing clinical symptoms during the prodromal or preclinical phases of the disease. Having developed a simple and practical PsA screening questionnaire, he identified key risk factors including severe skin involvement, obesity, nail involvement, and a positive family history. Notably, skin severity, obesity, and nail disease are modifiable; effectively treating the skin and nails, along with promoting weight loss, can help reduce the risk of PsA development.

Dr. Zhou Yuan shared her team's latest research published in the JCI, which revealed crosstalk between skin and joint inflammation and identified CCL-8 as a potential biomarker for predicting PsA onset. She proposed a future strategy: intervening at a very early stage with JAK inhibitors or biologics for high-risk psoriasis patients who are asymptomatic but show elevated biomarker levels, potentially offering significant benefit.

Both experts agreed on the complementary importance of discovering objective biomarkers and valuing patient-reported symptoms, especially joint pain. This dialogue underscores the crucial role of dermatologists in the early management of PsA and highlights the promising future of integrating basic research with clinical practice to advance patient care.