中华皮肤科杂志 ›› 2017, Vol. 50 ›› Issue (8): 599-601.

• 研究报道 • 上一篇    下一篇

角膜炎、鱼鳞病、耳聋综合征一例

张超1,穆震2,刘志超3,孙颖1,韦方丽1,曹璨1   

  1. 1. 泰山医学院附属医院
    2. 山东省泰安市,泰山医学院附属医院皮肤科
    3. 泰山医学院附属医院皮肤科
  • 收稿日期:2016-08-08 修回日期:2016-09-16 出版日期:2017-08-15 发布日期:2017-08-01
  • 通讯作者: 穆震 E-mail:muzhen@sina.com

Keratitis, ichthyosis, and deafness syndrome: a case report

  • Received:2016-08-08 Revised:2016-09-16 Online:2017-08-15 Published:2017-08-01

摘要: 患儿女,10岁。出生后1个月头皮、口周、颈部、躯干、臀部及掌跖出现红斑,皮肤干燥粗糙,头发细软、稀疏,易折断。随着年龄增长,红斑基础上出现明显的角化过度和增厚。5岁时出现畏光、视力下降;8岁开始听力逐渐下降。体检:身高109 cm,体重19 kg。皮肤科检查:头发稀少细软,易断;头皮、口周、颈部、躯干、臀部大片棕褐色斑块、结痂;其上可见疣状增生,伴有皲裂、溢脓,有恶臭。四肢皮肤散在黑褐色角化性斑块。掌跖弥漫性角化过度。指(趾)甲增厚,浑浊变白,远端分离、变形。眼科检查:畏光,视力左眼0.5,右眼0.2;双侧球结膜充血,角膜浑浊、角膜血管增生。耳鼻喉科检查:双耳中度感音性耳聋。口腔科检查:牙釉质发育不全,牙间隙明显增宽。GJB2基因检测发现,患儿GJB2基因2号外显子c.C50T杂合突变。诊断:角膜炎、鱼鳞病、耳聋综合征。经口服阿维A治疗,症状明显缓解。

Abstract: Zhang Chao, Mu Zhen, Liu Zhichao, Sun Ying, Wei Fangli, Cao Can Department of Dermatology, Affiliated Hospital of Taishan Medical University, Taian 271000, Shandong, China Corresponding author: Mu Zhen, Email: muzhen@sina.com 【Abstract】 A 10 year-old female child developed erythema on the scalp, perioral area, neck, trunk, buttocks, palms and soles within 1 month after birth. Her skin was dry and rough, and the hairs were fine, soft, sparse and easily broken. As age advanced, typical hyperkeratosis and thickening of the skin occurred on an erythematous base. At the age of 5 years, the child developed photophobia and vision impairment. When the child was 8 years old, progressive hearing loss was observed. Physical examination revealed that the height and weight were 109 centimeters and 19 kilograms respectively. Skin examination showed fine, soft, sparse and easily-broken hair, large areas of brown plaques with crusts on the scalp, perioral area, neck, trunk and buttocks, and fissured, purulent and foul-smelling verrucous hyperplasia over these plaques. Brown to black hyperkeratotic plaques were scattered over the extremities, and diffuse hyperkeratosis occurred on the palms and soles. Both fingernails and toenails became thickened, cloudy and white with distal separation and deformation of the nail plate. As ophthalmic examination showed, the patient had photophobia, bilateral bulbar conjunctival hyperemia, corneal opacity and corneal vascular proliferation, and the visual acuity was 0.5 in the left eye and 0.2 in the right eye. Otolaryngological examination revealed moderate binaural sensorineural deafness. Stomatological examination showed enamel hypoplasia and diastema widening. Genetic testing showed a heterozygous mutation (c.C50T) in exon 2 of the gap junction protein beta 2 (GJB2) gene. Based on these clinical manifestations and examinations, the patient was diagnosed with keratitis, ichthyosis, and deafness (KID) syndrome. Skin lesions of the patient were significantly improved after the treatment with oral acitretin.