中华皮肤科杂志 ›› 2022, Vol. 55 ›› Issue (5): 417-421.doi: 10.35541/cjd.20210211

• 研究报道 • 上一篇    下一篇

儿童Sturge-Weber综合征皮疹分布的临床意义探讨

苏伟1    邓维1    孙雪峰2    张升1    刘晓雁1   

  1. 1首都儿科研究所附属儿童医院皮肤科,北京  100020;2首都儿科研究所附属儿童医院影像科,北京  100020
  • 收稿日期:2021-03-11 修回日期:2021-08-08 发布日期:2022-04-29
  • 通讯作者: 张升;刘晓雁 E-mail:15910839056@163.com; lxyd@vip.sohu.com
  • 基金资助:
    国家自然科学基金(82073461)

Clinical significance of lesion distribution in children with Sturge-Weber syndrome

Su Wei1, Deng Wei1, Sun Xuefeng2, Zhang Sheng1, Liu Xiaoyan1   

  1. 1Department of Dermatology, Children′s Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, China; 2Department of Radiology, Children′s Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, China
  • Received:2021-03-11 Revised:2021-08-08 Published:2022-04-29
  • Contact: Zhang Sheng; Liu Xiaoyan E-mail:15910839056@163.com; lxyd@vip.sohu.com
  • Supported by:
    National Natural Science Foundation of China(82073461)

摘要: 【摘要】 目的 分析儿童Sturge?Weber综合征(SWS)患者面部鲜红斑痣分布特征及颅脑影像学特点。方法 回顾性分析2017年7月至2020年8月在首都儿科研究所附属儿童医院皮肤科确诊的22例儿童SWS患者临床表现及影像学资料,探讨SWS患儿鲜红斑痣沿面部三叉神经分布特征及颅脑影像学特点。结果 22例患儿中,男10例,女12例,年龄0.08 ~ 9.92岁,中位年龄1.67岁。SWSⅠ型13例,Ⅱ型9例。鲜红斑痣分型:粉红型4例,年龄0.50 ~ 2.17岁;紫红型14例,年龄0.08 ~ 8.83岁;增厚型4例,年龄4.92 ~ 9.92岁;按颜面部三叉神经分布,三叉神经眼支(V1)区22例,上颌支(V2)区20例,下颌支(V3)区8例。眼部异常患儿17例,年龄0.08 ~ 9.92岁,其中青光眼11例,眼压增高5例,视力受损2例。青光眼患儿中,7例于2岁内发病,8例为单侧发病,3例为双侧发病,且与鲜红斑痣同侧。12例患儿颅脑影像学表现异常,主要为大脑皮层血管畸形,累及额叶、顶叶、颞叶及枕叶;其他表现为脑萎缩、点状出血、钙化灶、脑沟增宽、中线结构偏移、脑室脉络丛血管增多。11例患儿有癫痫症状,其他神经系统表现为发育迟缓、智力低下、肢体活动障碍等。结论 颜面部三叉神经V1及V2区分布的鲜红斑痣可能提示更高的SWS发病风险,应行眼科及颅脑影像学筛查及长期随访。

关键词: Sturge-Weber综合征, 葡萄酒色痣, 青光眼, 癫痫, 儿童, 影像学表现

Abstract: 【Abstract】 Objective To analyze distribution characteristics of facial port-wine stains and brain imaging features of children with Sturge-Weber syndrome (SWS). Methods Clinical and imaging data were collected from 22 children with confirmed SWS at Department of Dermatology, Children′s Hospital Affiliated to Capital Institute of Pediatrics from July 2017 to August 2020, and retrospectively analyzed. The distribution characteristics of port-wine stains along the facial trigeminal nerve and brain imaging features were investigated in these children with SWS. Results Among the 22 children, 10 were males and 12 were females. Their age ranged from 0.08 to 9.92 years, and the median age was 1.67 years. There were 13 cases of SWS type Ⅰ and 9 cases of SWS type Ⅱ. In terms of the port-wine stain type, 4 children were diagnosed with pink port-wine stains, aged from 0.50 to 2.17 years; 14 were diagnosed with purple port-wine stains, aged from 0.08 to 8.83 years; 4 were diagnosed with thickened port-wine stains, aged from 4.92 to 9.92 years. Port-wine stains were distributed in the ophthalmic (V1) division of trigeminal nerve in 22 patients, in the maxillary (V2) division in 20 patients, and in the mandibular (V3) division in 8 patients. There were 17 children with ocular abnormalities, aged from 0.08 to 9.92 years, including 11 with glaucoma, 5 with elevated intraocular pressure and 2 with visual impairment. Among the children with glaucoma, 7 developed glaucoma within 2 years of age, 8 suffered from unilateral glaucoma, and 3 from bilateral glaucoma, and glaucoma occurred on the same side as port-wine stains. Brain imaging abnormalities were observed in 12 children, and mainly included vascular malformations in the cerebral cortex involving the frontal, parietal, temporal and occipital lobes, as well as cerebral atrophy, punctate hemorrhage, calcification, sulcal widening, midline deviation and increased intraventricular choroid plexus vessels. Eleven children had symptoms of epilepsy and other neurological manifestations, including developmental delay, mental retardation and physical impairment. Conclusion Port-wine stains distributed in the V1 and V2 divisions of the facial trigeminal nerve may indicate a higher risk of SWS, and ophthalmic and brain imaging screening as well as long-term follow-up should be performed.

Key words: Sturge-Weber syndrome, Port-Wine stain, Glaucoma, Epilepsy, Child, Imaging manifestations

引用本文

苏伟 邓维 孙雪峰 张升 刘晓雁. 儿童Sturge-Weber综合征皮疹分布的临床意义探讨[J]. 中华皮肤科杂志, 2022,55(5):417-421. doi:10.35541/cjd.20210211

Su Wei, Deng Wei, Sun Xuefeng, Zhang Sheng, Liu Xiaoyan. Clinical significance of lesion distribution in children with Sturge-Weber syndrome[J]. Chinese Journal of Dermatology, 2022, 55(5): 417-421.doi:10.35541/cjd.20210211