中华皮肤科杂志

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红皮病性银屑病193例分析

杨竹生, 林麟, 崔盘根, 曾学思, 陈志强, 贾虹, 李和莲, 孙建方, 弓娟琴, 刘训荃, 顾恒, 曹元华, 杨雪源, 周展超, 刘维达, 常宝珠   

  1. 中国医学科学院皮肤病研究所, 南京, 210042
  • 收稿日期:2006-11-30 出版日期:2007-10-15 发布日期:2007-10-15
  • 通讯作者: 林麟,email:linlin2003@medmail.com.cn E-mail:linlin2003@medmail.com.cn

A clinical analysis of 193 cases of erythrodermic psoriasis

YANG Zhu-sheng, LIN lin, CUI Pan-gen, ZENG Xue-si, CHEN Zhi-qiang, JIA Hong, LI He-lian, SUN Jian-fang, GONG Juan-qin, LIU Xun-quan, GU Heng, CAO Yuan-hua, YANG Xue-yuan, ZHOU Zhan-chao, LIU Wei-da, CHANG Bao-zhu   

  1. Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing 210042, China
  • Received:2006-11-30 Online:2007-10-15 Published:2007-10-15

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摘要： 目的 分析红皮病性银屑病的临床表现、不同治疗方案的疔效及安全性。方法 回顾性分析1999-2005年我院收治的193例红皮病性银屑病患者的临床资料。结果 193例中男女之比为1.6:1,平均发病年龄38岁,自既往其他类型银屑病转化为红皮病性银屑病的平均时间为13年。伴有脓疱23例(局限性17例、泛发性6例),关节痛21例。入院时异常化验结果主要包括外周血白细胞升高94例.白蛋白下降71例,肝功能异常32例。诱因主要为药物、感染、精神因素、局部药物刺激等。雷公藤多甙、阿维A、阿维A联合雷公藤多甙、甲氨蝶呤联合雷公藤多甙治疗红皮病性银屑病的有效率分别为62.01%、73.68%、76.59%、76.92%。结论 雷公藤多甙、阿维A、甲氨蝶呤治疗红皮病性银屑病有效,但其潜在的不良反应限制其长期应用。使用这些药物治疗时,不仅要注意其疗效,还须考虑其不良反应,以个性化治疗为宜。

关键词: 银屑病, 药用制剂, 总结性报告

Abstract: Objective To analyze the clinical features of erythrodermic psoriasis,and to compare the safety and efficacy of different treatment modalities for this condition.Methods The cIinical data from 193 inpatients with erythrodermic psoriasis collected at the institute from 1999 to 2005 were analyzed retrospectively.Results of these patients,the male:female ratio was 1.6:1,average age was 38 years.The average interval between the onset of psoriasis and first erythrodermic flare was 13 years(varying from 2 months to 50 years).Twenty-three patients had pustules(6 generalized,17 localized),and 21 had arthralgia.Abnormal laboratory results included decrease of serum albumin in 71 cases,increase of peripheral blood leucocytes in 94 cases and elevated liver function tests in 32 cases.Precipitating factors included medications,infections, psychological factors,and local irritation of topical therapy.The efficacy rates of Triptergium glucosides (TⅡ),acitretin,acitretin combined with TⅡ,methotrexate(MTX)combined with TⅡ were 62.01%, 73.68%,76.59%,and 76.92%,respectively.Conclusions TⅡ,MTX and systemic retinoids have proven to be highly effective in the treatment of erythrodermic psoriasis,but potential adverse reactions limit their longterm use.Therefore,the risk/benefit of these systemic remedies must be weighed carefully for each patient,and individualized treatment is recommended.

Key words: Psoriasis, Pharmaceutical preparations, Consensus development conferences