中华皮肤科杂志

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84例泛发性脓疱性银屑病临床分析

晋红中, 彭军, 王宝玺   

  1. 中国医学科学院、中国协和医科大学北京协和医院, 北京 100730
  • 收稿日期:2005-03-22 出版日期:2006-03-15 发布日期:2006-03-15

A clinical analysis of 84 cases of generalized pustular psoriasis

JIN Hong-zhong, PENG Jun, WANG Bao-xi   

  1. Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
  • Received:2005-03-22 Online:2006-03-15 Published:2006-03-15

摘要: 目的 探讨泛发性脓疱性银屑病(GPP)的临床特征,比较不同治疗方法的疗效.方法 根据病情严重程度,分析近10年我科收治的84例GPP.结果 既往有银屑病史和初发即为脓疱性银屑病患者各占50.0%.16.6%患者发生并发症,部分GPP皮损存在继发感染,既往有银屑病史的患者发病多与糖皮质激素使用有关;实验室检查中常见血红蛋白下降,外周血白细胞升高,肝功能异常,血白蛋白下降.结合疗效和不良反应综合考虑,治疗GPP时,首选阿维A.对于重度GPP,除非病情非常严重,其他药物难以控制急性症状,一般不必加用糖皮质激素.结论 对泛发性脓疱性银屑病应先行诊断,其次评估病情严重程度,再合理选择药物治疗.

关键词: 银屑病, 药物疗法

Abstract: Objective To study the clinical characteristics of generalized pustular psoriasis (GPP) and to compare the efficacy of different remedies. Methods A total of 84 patients with GPP collected from 1995 to 2004 were analysed according to the severity of the disease. Results The patients with a history of psoriasis vulgaris and those without the history of psoriasis vulgaris accounted for 50%, 50%, respectively. Of the GPP patients, 16.6% developed complications. A secondary infection occurred in partial patients. Clinically the outbreak of GPP was earlier in patients without the history of psoriasis than those with a history of psoriasis, which often occurred following corticosteroid therapy. Sudden withdrawal of corticosteroids was also an important inducing factor of GPP. Abnormal laboratory examination Results included the decrease of hemoglobin and serum albumin, the increase of peripheral blood leucocytes and liver enzymes. Considering the efficacy and side effects, acitretin was the first choice for GPP; corticosteroids were unnecessary for severe GPP unless the acute symptom could not be controlled with other drugs. Conclusion It is suggested that appropriate drug therapy be chosen based on the disease severity after the diagnosis of GPP is established.

Key words: Psoriasis, Drug therapy