掌跖脓疱病女性患者钙平衡紊乱且有高的糖尿病和精神病患病率:病例对照研究

作     者：Hagforsen E. Micha■lsson K. Lundgren E. 惠海英 

作者机构：E.Hagforsen Department of Medical Sciences Dermatology and Venereology University Hospital S- 751 85 Uppsala Sweden 

出 版 物：《世界核心医学期刊文摘（皮肤病学分册）》 (Digest of the World Core Medical JOurnals:Dermatology)

年 卷 期：2005年第1卷第8期

页      面：40-41页

学科分类：1002[医学-临床医学] 100206[医学-皮肤病与性病学] 10[医学] 

主　　题：掌跖脓疱病 钙平衡紊乱 病例对照研究 血清钙 末端汗管 甲状旁腺素 免疫荧光 皮肤疾病 吸烟人数 健康受试者 

摘      要：Palmoplantar pustulosis is characterized by pustule formation in the acrosyringium. Nearly 50% of palmoplantar pustulosis sera produce immunofluorescence of the palmar papillary endothelium from healthy subjects, but also of the endothelium of normal parathyroid gland. With a case- control design the levels of calcium and parathyroid hormone in serum were measured in 60 women with palmoplantar pustulosis and 154 randomly selected population- based control women. One- third of the controls had been smokers, whereas 95% of the cases were or had been smokers. Mean age- adjusted serum calcium was increased in the patients compared with the controls (2.43 vs 2.36 mmol/l; P 0.0001), whereas the parathyroid hormone concentration was suppressed (23.2 vs 31.1 ng/l; P 0.0001). The plasma levels of parathyroid hormone- related protein were normal in patients but there was a strong expression of this protein in the acrosyringium both in palmoplantar pustulosis and control skin. As even a marginal elevation of serum calcium is associated with an increased risk for diabetes, cardiovascular disease and psychiatric disease, we analysed the risk for these disorders in palmoplantar pustulosis patients compared with that in the control group. Both diabetes mellitus and psychiatric disorders were associated with palmoplantar pustulosis with an odds ratio of 8.7 (95% CI 3.3- 22.8) and 5.6 (95% CI 2.2- 14.4), respectively. Palmoplantar pustulosis is a complex disease with an increased risk for several non- dermatological disorders. The role of the mildly increased serum calcium for the high risk for diabetes and depression deserves to be studied.