中华皮肤科杂志 ›› 2014, Vol. 47 ›› Issue (8): 533-537.

• 论著 •    下一篇

中国头皮银屑病的特征和影响因素调查

鞠梅1,王刚2,郑敏3,晋红中4,顾恒5   

  1. 1. 南京 中国医学科学院北京协和医学院皮肤病医院
    2. 第四军医大学西京医院皮肤科
    3. 杭州:浙江大学医学院附属第二医院
    4. 中国医学科学院北京协和医学院北京协和医院
    5. 中国医学科学院北京协和医学院皮肤病研究所
  • 收稿日期:2013-11-13 修回日期:2014-05-14 发布日期:2014-08-01
  • 通讯作者: 顾恒 E-mail:guheng@aliyun.com

Scalp psoriasis in China: a survey on epidemiological characteristics and influencing factors

,WANG Gang,Min Zheng, ,   

  • Received:2013-11-13 Revised:2014-05-14 Published:2014-08-01

摘要: 【摘要】 目的 以医院为基础,通过多地区、大样本量调查,了解中国头皮银屑病的疾病特征和影响因素。 方法 在中国11个省和 4个直辖市,选择42家医院作为调查点,所有接受调查的头皮银屑病患者填写问卷并经皮肤科医生检查,所获得的调查表数据录入EpiData软件,利用WPS表格软件系统和Epi Info 5.0统计软件进行描述性分析。 结果 共抽样调查3 901份,资料完整的3 586份,男女比例1.6 ∶ 1。出现头皮损害的年龄(27.40 ± 13.34)岁,头皮银屑病严重程度指数(PSSI,13.61 ± 12.31),皮损位置以前发际居多(74.3%)。31.7%患者每年病程持续3 ~ 6个月,46%患者头皮皮损面积 < 25%头皮面积;皮损中,以鳞屑(92.1%)最为明显,其次是红斑(80.6%)、瘙痒(76.7%)、束状发(39.9%),18.0%患者出现脱发。病情加重有明显的季节性(76.7%),情绪(47.4%)、压力(47.1%)、劳累(46.6%)也是重要的诱发因素。70.5%患者对生活质量有不同程度的影响,尤其是社交、外出活动及娱乐等方面。17.8%患者接受了联合治疗(系统 + 局部治疗),单用局部治疗药物中,使用最多的是糖皮质激素软膏(27.5%)、卡泊三醇搽剂(22.7%)和糖皮质激素溶液(11.9%)。仅38.6%患者遵照医嘱、按药物治疗使用的要求坚持使用3 ~ 5周,35.2%患者认为疗效没有预期的好是影响治疗依从性的主要原因。理想的治疗头皮银屑病的药物不仅疗效好(50.3%)、安全性高(17.8%),而且要起效快(11.9%)、使用方便(11.0%)。 结论 头皮银屑病主要发病部位在前额发际,鳞屑为其主要体征,冬春季节是诱发加重的重要因素。多数头皮银屑病患者的生活质量受到不同程度的影响;治疗首选糖皮质激素和非激素类药物联合局部外用。患者认为理想的药物应该疗效好、安全性高,使用方便。

关键词: 银屑病, 头皮, 疾病特征, 数据收集

Abstract: Ju Mei *, Wang Gang, Zheng Min, Jin Hongzhong, Gu Heng. *Hospital of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China Corresponding authors: Gu Heng, Email: guheng@aliyun.com; Jin Hongzhong, Email: jinhongzhong@263.net 【Abstract】 Objective To describe epidemiological characteristics of scalp psoriasis in China, and to determine its influencing factors through a hospital-based, multicenter and large-scale survey. Methods An epidemiological survey was conducted on patients with scalp psoriasis in 42 hospitals in 11 provinces and 4 municipalities. A questionnaire was designed to collect general and clinical information of patients, including clinical type, lesion distribution, psoriasis scalp severity index (PSSI), aggravating factors, influence on quality of life, treatment course, degree of satisfaction with treatment, etc. Participants were asked to fill out the questionnaire with the help of well-trained dermatologists. Data were processed with the EpiData software. The WPS system and Epi Info 5.0 statistics software were used for descriptive analysis of the data. Results Totally, 3 901 patients participated this study, and 3 586 valid questionaires were obtained. The mean age at onset of scalp lesions was (27.40 ± 13.34) years, and the male to female ratio was 1.6 ∶ 1 with a mean PSSI score of 13.61 ± 12.31. The hairline of the forehead was the most frequently affected area with the constituent ratio of forehead psoriasis being 74.3% (2 663/3 586). The duration of scalp psoriasis reached 3 to 6 months every year in 1 136 (31.7%) patients, and the area affected by scalp psoriasis was less than 25% of the total surface area of the scalp in 1 649(46%) patients. The most frequent clinical presentation was scaling (92.1%), followed by erythema (80.6%), itching(76.7%), bunchy hairs(39.9%) and hair loss(18.0%). Disease aggravation was most frequently associated with seasons (76.7%), emotions (47.4%), stress (47.1%) and fatigue (46.6%). The quality of life (especially social, outdoor and entertainment activities) was reported to be negatively influenced by this entity to different degrees in 2 529 (70.5%) patients. Of these patients, 583 (17.8%) received combination therapy (topical and systemic), with glucocorticoid ointment (27.5%), calcipotriol scalp solution(22.7%) and glucocorticoid-containing solution (11.9%) being the most commonly used topical drugs; only 38.6% complied with medication requirements and doctors′ advice for 3 to 5 weeks, and 35.2% believed that the primary reason for poor compliance was unsatisfactory response to drugs. It was considered that an ideal drug for the treatment of scalp psoriasis should be highly effective (50.3%), safe (17.8%) and easy to apply (11%) with a rapid onset of action(11.9%). Conclusions Scalp psoriasis has a predilection for the hairline of the forehead with scaling as the main clinical presentation. Winter and spring seasons appear to be the most common aggravating factor of scalp psoriasis. The quality of life is negatively influenced to different degrees in many patients with scalp psoriasis. Topical corticosteroids plus non-hormonal drugs should be the first choice for the treatment of scalp psoriasis. Patients consider that the ideal drugs for the treatment of scalp psoriasis should be effective, safe, and easy to apply.

Key words: Psoriasis, Scalp, Disease attributes, Data collection

引用本文

鞠梅 王刚 郑敏 晋红中 顾恒. 中国头皮银屑病的特征和影响因素调查[J]. 中华皮肤科杂志, 2014,47(8):533-537. doi:

WANG Gang Min Zheng. Scalp psoriasis in China: a survey on epidemiological characteristics and influencing factors[J]. Chinese Journal of Dermatology, 2014, 47(8): 533-537.doi: