中华皮肤科杂志 ›› 2001, Vol. 30 ›› Issue (1): 9-11.

• 论著 •    下一篇

两型亚急性皮肤型红斑狼疮病情演变的分离现象

张建中1, 金江1, 郭利劭1, 马圣清2   

  1. 1. 北京大学人民医院皮肤科, 100044;
    2. 北京大学第一医院皮肤科
  • 收稿日期:2000-02-14 出版日期:2001-02-15 发布日期:2001-02-15

Different Prognoses of Two Types of Subacute Cutaneous Lupus Erythematosus: A Follow-up of 40 Cases

ZHANG Jianzhong1, JIN Jiang1, GUO Lishao1   

  1. Department of Dermatology, People's Hospital, Peking University, Beijing 100044
  • Received:2000-02-14 Online:2001-02-15 Published:2001-02-15

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摘要： 目的 探讨两型亚急性皮肤型红斑狼疮(SCLE)患者病情演变的差异.方法 对40例SCLE患者进行3～14年的随访分析,比较两型SCLE患者临床表现和实验室检查异常变化、治疗反应及预后.结果 在随访中,环形红斑型患者的疹型变化较少,病情较轻,部分患者出现干燥症状;而丘疹鳞屑型患者中大部分逐渐演变成SLE.环形红斑型患者仅21.7%发生轻度肾脏受累,皮质类固醇用量较小,无死亡病例;丘疹鳞屑型患者中64.7%发生肾脏受累,皮质类固醇用量较大或合并使用免疫抑制剂,1例死亡,3例发展为尿毒症.结论 环形红斑型是SCLE中较为良性的一型,预后较好,而丘疹鳞屑型则易发展为SLE,预后较差.

关键词: 红斑狼疮,亚急性皮肤, 预后

Abstract: Objective To investigate the prognosis of two subtypes of subacute cutaneous lupus erythematosus (SCLE). Methods Forty patients with subacute cutaneous lupus erythematosus were followed-up for 3 to 14 years. The clinical and laboratory findings,the response to treatment and the prognosis in these cases were comparatively analyzed. Results During the follow-up period,the patients with annular erythema subtype of SCLE showed recurrent annular skin lesions and mild systemic manifestations. Some patients gradually developed sicca symptoms. On the other hand,most patients with papulosquamous subtype of SCLE developed systemic LE manifestions. 21.7% of the patients in the annular erythema group had mild nephritis which could be controlled by lower dose of corticosteroids and no patients died. However,64.7% of the patients in the papulosquamous group had moderate to severe lupus nephritis,which required higher dose of corticosteroids or immunosuppressive agents to control. Among them,One patient died and 3 patients developed uremia. Conclusion Annular erythema subtype of SCLE is milder and has a better prognosis than that of papulosquamous subtype.

Key words: Lupus erythematosus,subacute cutaneous, Prognosis