中华皮肤科杂志 ›› 2025, e20240001.doi: 10.35541/cjd.20240001
张亮亮1 张家安2 陈崑2
收稿日期:2024-01-02
修回日期:2024-09-05
发布日期:2025-09-24
通讯作者:
陈崑
基金资助:Zhang Liangliang1, Zhang Jiaan2, Chen kun2
Received:2024-01-02
Revised:2024-09-05
Published:2025-09-24
Supported by:摘要: 【摘要】 头皮是银屑病最常受累和最先发病的部位,也是最难治疗的部位之一。头皮独特的毛发生长周期和复杂的微生物群落可能导致头皮银屑病的特征性皮损。近年来头皮银屑病的治疗取得巨大进展,生物制剂和小分子抑制剂均有效,新的外用药物和光疗方法正在探索中。本文对头皮银屑病的发病机制和治疗进展进行综述。
张亮亮 张家安 陈崑. 头皮银屑病发病机制和治疗的研究进展[J]. 中华皮肤科杂志, 2025,e20240001. doi:10.35541/cjd.20240001
Zhang Liangliang, Zhang Jiaan, Chen kun . Pathogenesis and treatment of scalp psoriasis[J]. Chinese Journal of Dermatology,2025,e20240001. doi:10.35541/cjd.20240001
| [1] | 胡煜, 顾恒, 陈崑. 中国中重度银屑病疾病负担和未满足治疗需求的系统综述[J]. 中华皮肤科杂志, 2023,56(10):965⁃972. doi: 10.35541/cjd.20230063. |
| [2] | Camela E, Ocampo⁃Garza SS, Cinelli E, et al. Therapeutic update of biologics and small molecules for scalp psoriasis: a systematic review[J]. Dermatol Ther, 2021,34(2):e14857. doi: 10.1111/dth.14857. |
| [3] | Honma M, Hayashi K. Psoriasis: recent progress in molecular⁃targeted therapies[J]. J Dermatol, 2021,48(6):761⁃777. doi: 10.1111/1346⁃8138.15727. |
| [4] | Committee of Psoriasis, Dermatology Branch, Chinese Medical Association.Guidelines for the diagnosis and treatment of psoriasis in China: 2019 concise edition#[J].Int J Dermatol Venerol, 2020,3(1):14⁃26. doi: 10.1097/JD9.0000000000000074. |
| [5] | Mosca M, Hong J, Hadeler E, et al. Scalp psoriasis: a literature review of effective therapies and updated recommendations for practical management[J]. Dermatol Ther (Heidelb), 2021,11(3):769⁃797. doi: 10.1007/s13555⁃021⁃00521⁃z. |
| [6] | Zhang YJ, Sun YZ, Gao XH, et al. Integrated bioinformatic analysis of differentially expressed genes and signaling pathways in plaque psoriasis[J]. Mol Med Rep, 2019,20(1):225⁃235. doi: 10.3892/mmr.2019.10241. |
| [7] | Brembilla NC, Senra L, Boehncke WH. The IL⁃17 family of cytokines in psoriasis: IL⁃17A and beyond[J]. Front Immunol, 2018,9:1682. doi: 10.3389/fimmu.2018.01682. |
| [8] | Ahn R, Yan D, Chang HW, et al. RNA⁃seq and flow⁃cytometry of conventional, scalp, and palmoplantar psoriasis reveal shared and distinct molecular pathways[J]. Sci Rep, 2018,8(1):11368. doi: 10.1038/s41598⁃018⁃29472⁃w. |
| [9] | Liu S, Zhuang Z, Liu F, et al. Identification of potential biomarkers and infiltrating immune cells from scalp psoriasis[J]. Gene, 2024,893:147918. doi: 10.1016/j.gene.2023.147918. |
| [10] | Suzuki T, Ito T, Gilhar A, et al. The hair follicle⁃psoriasis axis: shared regulatory mechanisms and therapeutic targets[J]. Exp Dermatol, 2022,31(3):266⁃279. doi: 10.1111/exd.14462. |
| [11] | Lousada MB, Lachnit T, Edelkamp J, et al. Exploring the human hair follicle microbiome[J]. Br J Dermatol, 2021,184(5):802⁃815. doi: 10.1111/bjd.19461. |
| [12] | Liu X, Cai Q, Yang H, et al. Distribution of Malassezia species on the skin of patients with psoriasis[J]. J Mycol Med, 2021,31(2):101111. doi: 10.1016/j.mycmed.2021.101111. |
| [13] | Tao R, Wan Z, Li RY, et al. Integrated skin microbiome⁃metabolome analysis reveals altered bacterial community composition and metabolites in psoriasis[J]. Int J Dermatol Venereol, 2023,6(4):181⁃188. doi: 10.1097/JD9.00000000000 00350. |
| [14] | Kayıran MA, Sahin E, Koçoğlu E, et al. Is cutaneous microbiota a player in disease pathogenesis? Comparison of cutaneous microbiota in psoriasis and seborrheic dermatitis with scalp involvement[J]. Indian J Dermatol Venereol Leprol, 2022,88(6):738⁃748. doi: 10.25259/IJDVL_323_21. |
| [15] | Schlager JG, Rosumeck S, Werner RN, et al. Topical treatments for scalp psoriasis: summary of a cochrane systematic review[J]. Br J Dermatol, 2017,176(3):604⁃614. doi: 10.1111/bjd.14811. |
| [16] | Ramic L, Sator P. Topical treatment of psoriasis vulgaris[J]. J Dtsch Dermatol Ges, 2023,21(6):631⁃642. doi: 10.1111/ddg. 15042. |
| [17] | Gao JC, Emmerich VK, Feldman S, et al. Evaluating calcipotriene 0.005% foam for the treatment of plaque psoriasis of the scalp and body in patients aged 12 years and older[J]. Expert Opin Pharmacother, 2021,22(5):543⁃547. doi: 10.1080/14656566.2020.1853099. |
| [18] | Kircik LH, Alonso⁃Llamazares J, Bhatia N, et al. Once⁃daily roflumilast foam 0.3% for scalp and body psoriasis: a randomized, double⁃blind, vehicle⁃controlled phaseⅡb study[J]. Br J Dermatol, 2023,189(4):392⁃399. doi: 10.1093/bjd/ljad182. |
| [19] | 周玲慧. 抗人白介素⁃8单克隆抗体乳膏治疗头皮银屑病的疗效观察[D].宁夏医科大学, 2022. doi: 10.27258/d.cnki.gnxyc. 2022.000096. |
| [20] | Heidemeyer K, Kulac M, Sechi A, et al. Lasers for the treatment of psoriasis: a systematic review[J]. Expert Rev Clin Immunol, 2023,19(7):717⁃744. doi: 10.1080/1744666X.2023.2205640. |
| [21] | 中华医学会皮肤性病学分会银屑病专业委员会. 中国银屑病诊疗指南(2023版)[J]. 中华皮肤科杂志, 2023,56(7):573⁃625. doi: 10.35541/cjd.20220839. |
| [22] | Schlager JG, Rosumeck S, Werner RN, et al. Topical treatments for scalp psoriasis[J]. Cochrane Database Syst Rev, 2016,2(2):CD009687. doi: 10.1002/14651858.CD009687.pub2. |
| [23] | Bagel J, Lynde C, Tyring S, et al. Moderate to severe plaque psoriasis with scalp involvement: a randomized, double⁃blind, placebo⁃controlled study of etanercept[J]. J Am Acad Dermatol, 2012,67(1):86⁃92. doi: 10.1016/j.jaad.2011.07.034. |
| [24] | Fotiadou C, Lazaridou E, Sotiriou E, et al. Scalp psoriasis and biologic agents: a retrospective, comparative study from a tertiary psoriasis referral centre[J]. J Eur Acad Dermatol Venereol, 2016,30(12):2091⁃2096. doi: 10.1111/jdv.13780. |
| [25] | Noda S, Mizuno K, Adachi M. Treatment effect of adalimumab and infliximab in Japanese psoriasis patients: results in a single community⁃based hospital[J]. J Dermatol, 2012,39(3):265⁃268. doi: 10.1111/j.1346⁃8138.2011.01312.x. |
| [26] | Thaçi D, Unnebrink K, Sundaram M, et al. Adalimumab for the treatment of moderate to severe psoriasis: subanalysis of effects on scalp and nails in the BELIEVE study[J]. J Eur Acad Dermatol Venereol, 2015,29(2):353⁃360. doi: 10.1111/jdv.12553. |
| [27] | Khobzey K, Liskova I, Szegedi A, et al. Effectiveness of adalimumab in the treatment of scalp and nail affection in patients with moderate to severe plaque psoriasis in routine clinical practice[J]. Acta Dermatovenerol Alp Pannonica Adriat, 2017,26(1):11⁃14. doi: 10.15570/actaapa.2017.3. |
| [28] | Bagel J, Duffin KC, Moore A, et al. The effect of secukinumab on moderate⁃to⁃severe scalp psoriasis: results of a 24⁃week, randomized, double⁃blind, placebo⁃controlled phase 3b study[J]. J Am Acad Dermatol, 2017,77(4):667⁃674. doi: 10.1016/j.jaad.2017.05.033. |
| [29] | Rompoti N, Katsimbri P, Kokkalis G, et al. Real world data from the use of secukinumab in the treatment of moderate⁃to⁃severe psoriasis, including scalp and palmoplantar psoriasis: a 104⁃week clinical study[J]. Dermatol Ther, 2019,32(5):e13006. doi: 10.1111/dth.13006. |
| [30] | Reich K, Leonardi C, Lebwohl M, et al. Sustained response with ixekizumab treatment of moderate⁃to⁃severe psoriasis with scalp involvement: results from three phase 3 trials (UNCOVER⁃1, UNCOVER⁃2, UNCOVER⁃3)[J]. J Dermatolog Treat, 2017,28(4):282⁃287. doi: 10.1080/09546634.2016.1249820. |
| [31] | Langley RG, Papp K, Gooderham M, et al. Efficacy and safety of continuous every⁃2⁃week dosing of ixekizumab over 52 weeks in patients with moderate⁃to⁃severe plaque psoriasis in a randomized phaseⅢ trial (IXORA⁃P)[J]. Br J Dermatol, 2018,178(6):1315⁃1323. doi: 10.1111/bjd.16426. |
| [32] | Langley RG, Rich P, Menter A, et al. Improvement of scalp and nail lesions with ixekizumab in a phase 2 trial in patients with chronic plaque psoriasis[J]. J Eur Acad Dermatol Venereol, 2015,29(9):1763⁃1770. doi: 10.1111/jdv.12996. |
| [33] | Elewski B, Rich P, Lain E, et al. Efficacy of brodalumab in the treatment of scalp and nail psoriasis: results from three phase 3 trials[J]. J Dermatolog Treat, 2022,33(1):261⁃265. doi: 10. 1080/09546634.2020.1749546. |
| [34] | Nakagawa H, Niiro H, Ootaki K. Brodalumab, a human anti⁃interleukin⁃17⁃receptor antibody in the treatment of Japanese patients with moderate⁃to⁃severe plaque psoriasis: efficacy and safety results from a phaseⅡ randomized controlled study[J]. J Dermatol Sci, 2016,81(1):44⁃52. doi: 10.1016/j.jdermsci.2015. 10.009. |
| [35] | Kokolakis G, Ghoreschi K. The clinical significance of simultaneous IL⁃17A and IL⁃17F blockade in psoriasis non⁃responding to anti⁃IL17A therapy[J]. J Clin Med, 2022,12(1):35. doi: 10.3390/jcm12010035. |
| [36] | Megna M, Picone V, Ventura V, et al. A case of scalp psoriasis resistant to ixekizumab treated with bimekizumab[J]. JAAD Case Rep, 2023,38:123⁃126. doi: 10.1016/j.jdcr.2023.05.043. |
| [37] | Blauvelt A, Papp KA, Griffiths CE, et al. Efficacy and safety of guselkumab, an anti⁃interleukin⁃23 monoclonal antibody, compared with adalimumab for the continuous treatment of patients with moderate to severe psoriasis: results from the phaseⅢ, double⁃blinded, placebo⁃ and active comparator⁃controlled VOYAGE 1 trial[J]. J Am Acad Dermatol, 2017,76(3):405⁃417. doi: 10.1016/j.jaad.2016.11.041. |
| [38] | Reich K, Armstrong AW, Foley P, et al. Efficacy and safety of guselkumab, an anti⁃interleukin⁃23 monoclonal antibody, compared with adalimumab for the treatment of patients with moderate to severe psoriasis with randomized withdrawal and retreatment: results from the phaseⅢ, double⁃blind, placebo⁃ and active comparator⁃controlled VOYAGE 2 trial[J]. J Am Acad Dermatol, 2017,76(3):418⁃431. doi: 10.1016/j.jaad.2016. 11.042. |
| [39] | Galluzzo M, Talamonti M, Cioni A, et al. Efficacy of tildrakizumab for the treatment of difficult⁃to⁃treat areas: scalp, nail, palmoplantar and genital psoriasis[J]. J Clin Med, 2022,11(9):2631. doi: 10.3390/jcm11092631. |
| [40] | Papp KA, Blauvelt A, Bukhalo M, et al. Risankizumab versus ustekinumab for moderate⁃to⁃severe plaque psoriasis[J]. N Engl J Med, 2017,376(16):1551⁃1560. doi: 10.1056/NEJMoa1607017. |
| [41] | Reich K, Rich P, Maari C, et al. Efficacy and safety of mirikizumab (LY3074828) in the treatment of moderate⁃to⁃severe plaque psoriasis: results from a randomized phaseⅡ study[J]. Br J Dermatol, 2019,181(1):88⁃95. doi: 10.1111/bjd.17628. |
| [42] | Orsini D, Gargiulo L, Ibba L, et al. Effectiveness of risankizumab in plaque psoriasis with involvement of difficult⁃to⁃treat areas: a real⁃world experience from two referral centers[J]. J Dermatolog Treat, 2023,34(1):2220849. doi: 10.1080/09546634.2023.2220849. |
| [43] | 王玲艳, 潘靖, 苗钢, 等. 对生物制剂治疗抵抗的银屑病患者皮损部位分析[J]. 中华皮肤科杂志, 2022,55(7):583⁃587. doi: 10.35541/cjd.20220133. |
| [44] | Keating GM. Apremilast: a review in psoriasis and psoriatic arthritis[J]. Drugs, 2017,77(4):459⁃472. doi: 10.1007/s40265⁃017⁃0709⁃1. |
| [45] | Blauvelt A, Rich P, Sofen H, et al. Deucravacitinib, a selective, allosteric tyrosine kinase 2 inhibitor, in scalp psoriasis: a subset analysis of two phase 3 randomized trials in plaque psoriasis[J]. J Am Acad Dermatol, 2024,90(4):775⁃782. doi: 10.1016/j.jaad.2023.11.060. |
| [46] | 王茜, 孙雪淞, 张丽宏, 等. 中药外治法治疗头皮型银屑病的Meta分析[J]. 云南中医中药杂志, 2023,44(1):31⁃37. doi: 10.3969/j.issn.1007⁃2349.2023.01.010. |
| [47] | 黄强, 龚丽萍. 头皮银屑病的中西医结合治疗进展[J]. 江西中医药, 2021,52(1):75⁃77. |
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