Purpose of Review

Psoriasis and psoriatic arthropathy are inflammatory autoimmune conditions that can lead to profound emotional distress, social stigmatization, isolation, disfigurement, pain, disability, unemployment, and decreased quality of life. Thus, this disease has immense psychological, social, and economic implications as the pain experienced is closely associated with the primary disease burden. This review focuses on discussing the primary disease burden of psoriasis and psoriatic arthropathy, as well as management of different types of pain in these patients.

Recent Findings

Pain affects over 40% of patients with psoriasis, ranging from neuropathic to nociceptive. Treatment of pain largely focuses on treating the underlying disease with mild topical steroids and non-steroidal medications including vitamin D analogs followed by systemic immunomodulatory agents for more severe disease. Interventional options such as corticosteroid injections are available for select cases (conditional recommendation).

Summary

Psoriasis and psoriatic arthropathy have been associated with underreporting and resultant undertreatment of pain. Pain control in these conditions is complex and requires a multidisciplinary approach. More research and guidelines are needed in the areas of reporting of psoriatic disease, associated pain, psoriatic nociception, and optimal clinical management.

中文翻译：

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疼痛性银屑病和银屑病关节病的疼痛管理：涉及多个系统的具有挑战性且错综复杂的问题

审查目的

银屑病和银屑病关节病是炎症性自身免疫性疾病，可导致严重的情绪困扰、社会污名化、孤立、毁容、疼痛、残疾、失业和生活质量下降。因此，这种疾病具有巨大的心理、社会和经济影响，因为所经历的疼痛与主要疾病负担密切相关。本综述重点讨论银屑病和银屑病关节病的主要疾病负担，以及对这些患者不同类型疼痛的管理。

最近的发现

疼痛影响超过 40% 的银屑病患者，范围从神经性到伤害性。疼痛的治疗主要集中在使用温和的局部类固醇和非类固醇药物（包括维生素 D 类似物）治疗潜在疾病，然后使用全身免疫调节剂治疗更严重的疾病。某些情况下可以使用皮质类固醇注射等干预措施（有条件推荐）。

概括

银屑病和银屑病关节病与报告不足和由此导致的疼痛治疗不足有关。这些情况下的疼痛控制很复杂，需要多学科的方法。在报告银屑病疾病、相关疼痛、银屑病伤害感受和最佳临床管理方面需要更多的研究和指南。