中华皮肤科杂志 ›› 2017, Vol. 50 ›› Issue (9): 623-625.

• 论著 •    下一篇

溃疡性结肠炎并发坏疽性脓皮病八例研究

江燕云1,李骥1,李玥2,李思倩3,徐蕙1,方凯4,晋红中1,钱家鸣1   

  1. 1. 中国医学科学院北京协和医学院北京协和医院
    2. 北京协和医院
    3. 北京协和医学院北京协和医院
    4.
  • 收稿日期:2016-11-15 修回日期:2016-12-05 出版日期:2017-09-15 发布日期:2017-08-31
  • 通讯作者: 晋红中 E-mail:jinhongzhong@126.com.cn

Clinical analysis of eight cases of ulcerative colitis complicated by pyoderma gangrenosum

  • Received:2016-11-15 Revised:2016-12-05 Online:2017-09-15 Published:2017-08-31

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摘要： 目的 探讨溃疡性结肠炎（UC ）并发坏疽性脓皮病（PG）患者的临床表现、组织病理特点及疗效。方法 2009年7月至2016年7月于北京协和医院住院的8例UC并发PG患者的临床表现、辅助检查及治疗转归等资料。结果 8例中男5例，女3例，男女平均发病年龄分别为30.6岁和35.1岁。8例UC肠道症状发病时间均早于PG的出现时间，平均间隔时间为5年。均为全结肠型，且PG出现时，UC均处于活动期，6例为中度活动，2例为轻度活动。PG均表现为皮肤疼痛性溃疡，7例累及下肢。5例患者的皮损组织病理可见典型血管炎改变。5例患者并发关节痛。8例患者均以糖皮质激素和5氨基水杨酸制剂作为基本治疗，其中3例联合免疫抑制剂或米诺环素，2例接受英夫利西单抗治疗。结论 PG是UC的严重皮肤表现，常出现于全结肠型、疾病活动的UC患者，多累及下肢，皮肤组织病理为典型血管炎改变。

Abstract: Jiang Yanyun, Li Ji, Li Yue, Li Siqian, Xu Hui, Fang Kai, Jin Hongzhong, Qian Jiaming Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China（Jiang YY, Fang K, Jin HZ）; Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China（Li J, Li Y, Xu H, Qian JM）; Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China （Li SQ） Corresponding authors: Jin Hongzhong, Email: jinhongzhong@263.net; Qian Jiaming, Email: qianjiaming 1957@126.com 【Abstract】 Objective To investigate clinical manifestations, histopathological features and treatment of ulcerative colitis（UC） complicated by pyoderma gangrenosum （PG）. Methods Data on clinical manifestations, auxiliary examination findings, treatment and prognosis were collected from 8 inpatients with UC complicated by PG in Peking Union Medical College Hospital between July 2009 and July 2016, and analyzed retrospectively. Results Of the 8 cases, 5 were male, and 3 were female. The average age of onset was 30.6 years and 35.1 years in males and females respectively. All the patients developed intestinal symptoms of UC before the onset of PG with an average time interval of 5 years. Moreover, all the patients had active total colonic type UC at the onset of PG, including 6 with moderately active UC and 2 with mildly active UC. PG manifested as painful ulcers in 8 patients, and affected lower limbs in 7 patients. Histopathological examination of skin lesions showed typical characteristics of vasculitis in 5 patients. Five patients were complicated by arthralgia. All the patients were treated with glucocorticoids and 5-aminosalicylic acid agents as the basic therapy, 3 patients received extra treatment with immuno-suppressive agents or minocycline, and 2 with infliximab. Conclusions PG is a severe skin manifestation of UC, commonly occurs in patients with total colonic type UC in the active stage, and mostly affects the lower limbs, with typical histopathological features of vasculitis.