早发型与晚发型银屑病的临床特点及遗传学研究

寻常性银屑病可根据年龄分为早发型与晚发型,许多学者就其遗传学和临床特点两方面进行了大量研究.最近的研究发现,早发型银屑病发病与等位基因rs10852936(17q12/IKZF3)突变等有关,晚发型银屑病发病则与白细胞介素1受体1等位基因中单核苷酸多态性rs887998、人白细胞抗原A中单核苷酸多态性rs2256919及等位基因人白细胞抗原C*12:02等有关.同时,地域间早发型与晚发型银屑病的临床特点也存在差异.早发型银屑病更易复发,易合并心理障碍;青春期发病患者发生点滴状皮损的概率高,且多与链球菌感染有关.晚发型银屑病易发生掌跖脓疱病、红皮病性银屑病,易合并糖耐量异常及肥胖症;老年发病患者家族史阳性率低,皮损较轻.

Clinical features and genetics of early-onset and late-onset psoriasis

Psoriasis vulgaris can be divided into early-onset and late-onset types based on age,a lot of researches have been conducted on their genetics and clinical characteristics.Recent studies have found that the allele T of rs10852936 (17q12/IKZF3) confers risk for early-onset psoriasis,while there are associations between late-onset psoriasis and single nucleotide polymorphism (SNP) rs887998 in the allele of interleukin-1 receptor type 1 (IL1R1),SNP rs2256919 in human leukocyte antigen A (HLA-A),as well as in HLA-C*12:02 allele.Meanwhile,the clinical features of early-onset and late-onset psoriasis differ between various regions.Early-onset psoriasis is more likely to recur and be complicated by psychological disorders.Guttate lesions are more common in pubertal children,and usually associated with streptococcal infections.Patients with late-onset psoriasis are susceptible to developing palmoplantar pustulosis,erythrodermic psoriasis,abnormal glucose tolerance and obesity.Elderly-onset patients have shown a lower prevalence of family history and generally milder lesions.