2010-2015年红皮病型银屑病84例,其他类型红皮病121例临床分析

Ping Zhang, Hong-Xiang Chen, Jian-Jun Xing, Zhao Jin, Feng Hu, Teng-Long Li, Xiao-Yong Zhou
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引用次数: 6

摘要

红皮病病因复杂,是严重的皮肤病之一,病死率高,在皮肤病中的发病率为0.5‰~ 1.5‰。红皮病型牛皮癣(EP)是最常见的红皮病类型。此外,还有药物性红皮病、继发于既往皮肤病的红皮病、恶性肿瘤相关红皮病和病因不明的特发性红皮病。不同病因的红皮病有不同的临床表现,导致不同的疗效和结局。本文回顾性分析205例红皮病患者的临床症状、辅助检查及治疗方法,并对其疗效及预后进行评价。205例患者中EP 84例,特异性药物所致红皮病10例,继发于既往皮肤病(不含牛皮癣)的红皮病77例,合并恶性肿瘤的红皮病7例,原因不明的红皮病27例。我们认为不同年龄组男性患者的病因有显著差异。EP的发生率在所有类型中最高。EP常伴有低蛋白血症,经治疗后转变为寻常型银屑病。药物性红皮病多伴有发热,多通过系统类固醇治疗治愈。对于继发于原有皮肤病的红皮病,必须积极治疗原有皮肤病,以达到满意的预后。恶性或原因不明的红皮病病程长,治疗效果差,复发率高。因此,明确病因,提供适当和个性化的治疗方案,定期随访是成功治疗不明原因红皮病的关键。
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Clinical analysis of 84 cases of erythrodermic psoriasis and 121 cases of other types of erythroderma from 2010-2015.

Erythroderma with complicated etiology is one of the severe skin diseases and has high mortality, of which the incidence was 0.5‰-1.5‰ in skin diseases. Erythrodermic psoriasis (EP) is the commonest type of erythroderma. In addition, there are drug-induced erythroderma, erythroderma secondary to preexisting dermatoses, malignancy-related erythroderma, and idiopathic erythroderma of unknown etiology. Erythroderma of different etiologies has various clinical manifestations, resulting in relevant curative effects and outcomes. In this article, we retrospectively investigated 205 erythroderma patients about clinical symptoms, auxiliary examination and treatments, and evaluated the efficacy and prognosis. There were 84 cases of EP among 205 patients, 10 cases of erythroderma caused by specific drugs, 77 cases of erythroderma secondary to preexisting dermatoses (excluding psoriasis), 7 cases of erythroderma patients suffering from malignancy and 27 cases with unknown causes. We concluded that the etiology of male patients in different age groups had significant difference. The incidence of EP was the highest among all types. The EP was commonly accompanied with hypoproteinemia, and changed into psoriasis vulgaris after treatment. Drug-induced erythroderma was commonly accompanied with fever, and mostly cured by systematic steroid therapy. For erythroderma secondary to preexisting dermatoses, the original dermatoses must be actively treated to achieve a satisfying prognosis. Erythroderma with malignancy or unknown causes had long-term duration, poor response to the treatment, and high potential to relapse. Therefore, clarifying the etiology, providing an appropiate and individual regimen, and regular follow-up are crucial for the successful treatment of erythroderma with unknown causes.

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