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Psoríase : fisiopatologia, tratamentos e abordagem multidisciplinar
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Abstract(s)
A psoríase é uma dermatose inflamatória crónica com uma marcada componente imunogenética, que afeta entre 2 a 3 % da população mundial. A sua fisiopatologia baseia- se numa ativação anómala dos linfócitos T, numa produção aumentada de citocinas pró- inflamatórias (TNF-α, IL-17, IL-23) e numa hiperproliferação dos queratinócitos, originando lesões eritemato-descamativas típicas.
Encontram-se descritas várias formas clínicas, incluindo a psoríase em placas (forma predominante), em gotas, pustulosa, eritrodérmica, ungueal e articular. Foram identificados diversos fatores desencadeantes ou agravantes, incluindo stress, infeções, medicamentos, tabagismo, e consumo de álcool.
A psoríase associa-se frequentemente a comorbilidades sistémicas, como a síndrome metabólica, doenças cardiovasculares e distúrbios de ansiedade e depressão, exigindo uma abordagem terapêutica global e individualizada. As opções terapêuticas incluem tratamentos tópicos, fototerapia, terapêuticas sistémicas clássicas e biotecnológicas direcionadas. Na ausência de uma cura definitiva, o objetivo principal consiste na melhoria sustentada da qualidade de vida. O farmacêutico desempenha um papel central na educação terapêutica, na promoção da adesão ao tratamento, e no aconselhamento higieno-dietético, no âmbito de uma abordagem multidisciplinar centrada no doente.
Psoriasis is a chronic inflammatory dermatosis with a marked immunogenetic component, affecting 2 to 3% of the world's population. Its pathophysiology is based on abnormal activation of T lymphocytes, increased production of pro-inflammatory cytokines (TNF-α, IL-17, IL-23), and keratinocyte hyperproliferation, resulting in typical erythematosquamous lesions. Several clinical forms have been described, including plaque psoriasis (the predominant form), guttate psoriasis, pustular psoriasis, erythrodermic psoriasis, nail psoriasis and joint psoriasis. Various triggering or aggravating factors have been identified, including stress, infections, medication, smoking, and alcohol consumption. Psoriasis is frequently associated with systemic comorbidities (metabolic syndrome, cardiovascular disease, anxiety disorders), warranting comprehensive, individualized management. Treatment options include topical treatments, phototherapy, standard systemic treatments, and targeted biotherapies. In the absence of a cure, the aim is to achieve a lasting improvement in quality of life. The role of the pharmacist is central to therapeutic education, promoting compliance and providing dietary advice, as part of a patient-centered, multidisciplinary approach.
Le psoriasis est une dermatose inflammatoire chronique à composante immunogénétique marquée, affectant 2 à 3 % de la population mondiale. Sa physiopathologie repose sur une activation anormale des lymphocytes T, une production accrue de cytokines pro- inflammatoires (TNF-α, IL-17, IL-23), et une hyperprolifération kératinocytaire, à l’origine de lésions érythémato-squameuses typiques. Plusieurs formes cliniques sont décrites, dont le psoriasis en plaques (forme prédominante), en gouttes, pustuleux, érythrodermique, unguéal, et articulaire. Divers facteurs déclenchants ou aggravants ont été identifiés : stress, infections, médicaments, tabagisme, et consommation d’alcool. Le psoriasis est fréquemment associé à des comorbidités systémiques (syndrome métabolique, pathologies cardiovasculaires, troubles anxiodépressifs), justifiant une prise en charge globale et individualisée. Les options thérapeutiques incluent traitements topiques, photothérapie, traitements systémiques classiques, et biothérapies ciblées. En l’absence de traitement curatif, l’objectif demeure l’amélioration durable de la qualité de vie. Le rôle du pharmacien est central dans l’éducation thérapeutique, la promotion de l’observance et le conseil hygiéno-diététique, dans une approche pluridisciplinaire centrée sur le patient.
Psoriasis is a chronic inflammatory dermatosis with a marked immunogenetic component, affecting 2 to 3% of the world's population. Its pathophysiology is based on abnormal activation of T lymphocytes, increased production of pro-inflammatory cytokines (TNF-α, IL-17, IL-23), and keratinocyte hyperproliferation, resulting in typical erythematosquamous lesions. Several clinical forms have been described, including plaque psoriasis (the predominant form), guttate psoriasis, pustular psoriasis, erythrodermic psoriasis, nail psoriasis and joint psoriasis. Various triggering or aggravating factors have been identified, including stress, infections, medication, smoking, and alcohol consumption. Psoriasis is frequently associated with systemic comorbidities (metabolic syndrome, cardiovascular disease, anxiety disorders), warranting comprehensive, individualized management. Treatment options include topical treatments, phototherapy, standard systemic treatments, and targeted biotherapies. In the absence of a cure, the aim is to achieve a lasting improvement in quality of life. The role of the pharmacist is central to therapeutic education, promoting compliance and providing dietary advice, as part of a patient-centered, multidisciplinary approach.
Le psoriasis est une dermatose inflammatoire chronique à composante immunogénétique marquée, affectant 2 à 3 % de la population mondiale. Sa physiopathologie repose sur une activation anormale des lymphocytes T, une production accrue de cytokines pro- inflammatoires (TNF-α, IL-17, IL-23), et une hyperprolifération kératinocytaire, à l’origine de lésions érythémato-squameuses typiques. Plusieurs formes cliniques sont décrites, dont le psoriasis en plaques (forme prédominante), en gouttes, pustuleux, érythrodermique, unguéal, et articulaire. Divers facteurs déclenchants ou aggravants ont été identifiés : stress, infections, médicaments, tabagisme, et consommation d’alcool. Le psoriasis est fréquemment associé à des comorbidités systémiques (syndrome métabolique, pathologies cardiovasculaires, troubles anxiodépressifs), justifiant une prise en charge globale et individualisée. Les options thérapeutiques incluent traitements topiques, photothérapie, traitements systémiques classiques, et biothérapies ciblées. En l’absence de traitement curatif, l’objectif demeure l’amélioration durable de la qualité de vie. Le rôle du pharmacien est central dans l’éducation thérapeutique, la promotion de l’observance et le conseil hygiéno-diététique, dans une approche pluridisciplinaire centrée sur le patient.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Psoríase Fisiopatologia Tratamentos Comorbilidades Farmacêutico Abordagem multidisciplinar