EADV 2026视频特辑｜Peter van de Kerkhof教授与史玉玲教授：银屑关节炎诊疗指南——早期诊断、风险分层与诊疗实践

史玉玲教授重点介绍了团队牵头制定的《中国关节病型银屑病（银屑病关节炎）诊疗指南（2026版）》——该指南以中英文双版本发表于《中华医学杂志》，旨在让全球专家了解中国银屑病关节炎的诊疗现状并开展合作。她介绍，指南只采用确凿证据，团队历时三年，系统检索所有参考文献与最新文献，以临床实践声明的形式，由全体专家共同开会拟定。指南建议采用超声等检查手段早期识别关节受累，尤其是亚临床关节炎；同时强调指甲受累、头皮受累、银屑病病史和皮损严重程度较高这四项风险因素，用于筛选需重点关注银屑病关节炎的患者。

Peter van de Kerkhof教授对此补充，不应等到患者满足银屑病关节炎分类标准（CASPAR）才确诊银屑病关节炎——此时患者可能已出现功能性损伤；借助超声早期诊断，就能抓住早期干预的良机。他还谈及与风湿科医生的协作：面对高风险患者主诉间断疼痛或僵硬的情况，应保持警惕，选择合适的影像检查，判断其是否会进展为明确的银屑病关节炎，并尽早治疗以预防发病。

最后，Peter van de Kerkhof教授总结道：过去二十多年，早期积极干预并非总能实现；未来，这将成为常规操作，而皮肤科医生的关注重点，应当不再是清除皮损，而是预防合并症，让所有患者都享有健康。

Professor Shi Yuling highlighted the Chinese Guidelines for the Diagnosis and Treatment of Psoriatic Arthritis (2026 Edition), which was developed under the leadership of her team. Published in bilingual Chinese and English in the Chinese Medical Journal, the guideline is designed to share China’s current diagnosis and management landscape of psoriatic arthritis with global experts and promote international cooperation.

As she noted, the guideline is grounded exclusively in robust clinical evidence. Over a three-year period, the team performed a systematic review of all relevant references and up-to-date literature, and the final clinical practice statement was finalized through consensus meetings among all expert panel members.

The guideline recommends the use of imaging tools such as ultrasonography to enable early identification of joint involvement, particularly subclinical arthritis. It also underscores four key risk factors — nail involvement, scalp involvement, psoriasis history, and high skin lesion severity — for screening patients who are at elevated risk of psoriatic arthritis and require focused clinical monitoring.

Professor Peter van de Kerkhof offered supplementary remarks, noting that the diagnosis of psoriatic arthritis should not wait until patients meet the CASPAR classification criteria, as functional impairment may already have developed by that point. Early diagnosis enabled by ultrasonography allows clinicians to capture the critical window for early intervention.

He also addressed collaboration with rheumatologists: clinicians should maintain a high index of suspicion when high-risk patients present with complaints of intermittent pain or stiffness. Appropriate imaging examinations should be arranged to evaluate whether the condition will progress to overt psoriatic arthritis, and early treatment should be initiated to prevent disease onset.

In conclusion, Professor Peter van de Kerkhof summarized that while early and aggressive intervention has not always been feasible over the past two decades, it will become routine clinical practice in the future. For dermatologists, the focus should no longer be solely on achieving skin clearance, but on preventing comorbidities to help all patients achieve sustained overall health.