儿童银屑病生物治疗与疫苗接种

The Application of Biological Agents and Vaccination in Pediatric Psoriasis

银屑病是一种免疫介导的、反复发作的炎症性皮肤病。生物制剂是治疗中重度儿童斑块型银屑病的重要手段之一。循证医学证据表明生物制剂治疗儿童银屑病具有良好疗效和安全性,但同时也增加了感染的易感性。接种疫苗是预防感染的重要措施,但银屑病患者疫苗接种率明显低于正常人群,与担忧疫苗接种加重银屑病、银屑病影响对疫苗的免疫反应、系统治疗影响疫苗效果等疫苗犹豫相关。儿童作为国家免疫规划的主要对象,其生物治疗期间的疫苗接种问题已成为皮肤科医生面临的常见问题之一。本文综述儿童银屑病生物治疗与疫苗接种研究进展,供医患决策疫苗接种时参考。

Psoriasis is an immune-mediated,recurrent inflammatory skin disease.Biological agents have been one of the most important treatment methods for moderate to severe pediatric plaque psoriasis.Available evidence have demonstrated the efficacy and safety of biologics in the treatment of pediatric psoriasis,while biologics could also increase susceptibility to infections.Vaccines play a crucial role in preventing infections,and rates of vaccination are significantly lower in psoriasis patients than in the normal population.Vaccine hesitancy in psoriasis relates to concerns that vaccination exacerbates psoriasis,that psoriasis affects the immune response to vaccines,and that systemic therapy affects vaccine efficacy.Children are the main population of the national immunization program.Issue of vaccination during the application of biologics in pediatric psoriasis has become one of the most important issues facing dermatologists.This article reviews the clinical issues related to the application of biologic therapy and vaccination in children with psoriasis.