中华皮肤科杂志 ›› 2017, Vol. 50 ›› Issue (3): 162-166.

• 论著 • 上一篇    下一篇

1 090例玫瑰痤疮患者临床特征分析及玫瑰痤疮新诊断标准探讨

汪犇1,李吉2,杨赛3,邓宇瑄4,简丹4,施为5,黄莹雪3,刘芳芬1,谢红付1   

  1. 1. 中南大学湘雅医院
    2. 长沙中南大学湘雅医院皮肤科
    3. 中南大学湘雅医院皮肤科
    4. 湘雅医院
    5. 长沙中南大学湘雅医院皮肤科 410008
  • 收稿日期:2016-07-07 修回日期:2016-12-16 发布日期:2017-03-01
  • 通讯作者: 谢红付 E-mail:xiehongfu1964@aliyun.com
  • 基金资助:
    miRNAs-DNMT1调节网络在皮肤角质形成细胞衰老中的作用及机制研究;水通道蛋白3在皮肤光老化中的机制研究;HOTAIR与DNMT1相互作用在皮肤细胞衰老中的机制研究;ZEB1调控DNMT1在维持小鼠表皮干细胞干性中的作用及机制;ZEB1调控DNMT1在维持小鼠表皮干细胞干性中的作用及机制

Clinical analysis of 1 090 cases of rosacea and exploration of new diagnostic criteria for rosacea

  • Received:2016-07-07 Revised:2016-12-16 Published:2017-03-01
  • Contact: Xie E-mail:xiehongfu1964@aliyun.com

摘要: 目的 在分析大样本玫瑰痤疮患者临床特征的基础上提出新的诊断标准。方法 纳入中南大学湘雅医院皮肤科门诊初诊的1 090例玫瑰痤疮患者,收集基本资料、临床症状和自觉症状等,根据描述性分析结果,总结玫瑰痤疮临床特点,探讨新的玫瑰痤疮诊断标准。以1 200例以面部红斑为主要临床特点的门诊病例为对象,验证新标准的灵敏度和特异度。结果 1 090例玫瑰痤疮患者,男131例(12.0%)、女959例(88.0%),年龄10 ~ 66(33.5 ± 11.1)岁。初始皮损发生在面颊部715例(65.6%),其中712例(99.6%)首发症状为阵发性潮红,689例(96%)伴有干燥、灼热、瘙痒等皮肤敏感症状;初始皮损发生在口周部208例(19.1%),其中204例(98.1%)首发症状为持久性红斑;皮损首发于鼻部167例(15.3%),其中163例(97.6%)首发症状为持久性红斑;伴有眼部症状311例(28.5%),伴有面部以外(颈部、耳后等)症状24例(2.2%)。由此拟定新的玫瑰痤疮诊断标准,必备条件:面颊/口周/鼻部阵发性潮红或持久性红斑;次要条件:①灼热、刺痛、干燥或瘙痒等皮肤敏感症状;②毛细血管扩张;③丘疹或脓疱;④肥大增生改变;⑤眼部症状。符合必备条件和1条及以上的次要条件,即可诊断为玫瑰痤疮。将新的诊断标准在1 200例以面部红斑为主要临床特点的面部皮炎患者中进行验证,其灵敏度为99.3%,特异度为95.8%。结论 提出了一个具有较好敏感性和特异性的玫瑰痤疮诊断标准,值得在临床工作中应用。

Abstract: Wang Ben, Li Ji, Yang Sai, Deng Yuxuan, Jian Dan, Shi Wei, Huang Yingxue, Liu Fangfen, Xie Hongfu Department of Dermatology, Xiangya Hospital, Central South University, Changsha 410008, China Corresponding author: Xie Hongfu, Email: xiehongfu1964@aliyun.com 【Abstract】 Objective To propose a new diagnostic criterion for rosacea based on the analysis of clinical features of rosacea in a large sample. Methods A total of 1 090 Chinese outpatients with rosacea were enrolled from Department of Dermatology of Xiangya Hospital, and their demographic data, clinical manifestations and subjective symptoms were collected. According to results of descriptive analysis, clinical features of rosacea were summarized, and a new diagnostic criterion for rosacea was set up. Then, the sensitivity and specificity of the new diagnostic criterion were verified among 1 200 outpatients clinically characterized by facial erythema. Results Of 1 090 patients with rosacea, 131 (12.0%) were male and 959(88.0%) were female, and the average age was 33.5 ± 11.1 years (range, 10 - 66). Among the 1 090 patients, 715 (65.6%) had initial lesions on the cheek, of whom, 712 (99.6%) had intermittent flushing as the initial symptom, and 689 (96%) had sensitive skin symptoms such as dryness, burning and itching sensations; 208 (19.1%) had initial lesions on the perioral region, of whom, 204 (98.1%) had persistent erythema as the initial symptom; 167 (15.3%) had initial lesions on the nose, of whom, 163 (97.6%) had persistent erythema as the initial symptom; in addition, 311 (28.5%) had lesions on the ocular region, and only 24 (2.2%) had lesions outside the face on the neck and retroauricular region. Based on these clinical features, a new diagnostic criterion for rosacea was proposed, including 1 major condition (intermittent flushing or persistent erythema on the cheek, perioral region or nose) and 5 minor conditions (1. sensitive skin symptoms such as burning, tingling, drying or itching sensations; 2. telangiectasia; 3. papules or pustules; 4. hypertrophy; 5. ocular symptoms). If with the major condition and at least one minor condition were met, patients could be diagnosed with rosacea. After verification among 1 200 patients with facial dermatitis clinically characterized by facial erythema, the new criterion was proved to have a sensitivity of 99.3% and a specificity of 95.8%. Conclusion A new diagnostic criterion for rosacea with high sensitivity and specificity is proposed, which is worthy of clinical application.

引用本文

汪犇 李吉 杨赛 邓宇瑄 简丹 施为 黄莹雪 刘芳芬 谢红付. 1 090例玫瑰痤疮患者临床特征分析及玫瑰痤疮新诊断标准探讨[J]. 中华皮肤科杂志, 2017,50(3):162-166. doi: