儿童白癜风和成人白癜风临床分析比较  

Analysis and comparison of vitiligo between children and adults

作　　者：康元[1] 张峻岭[2] 史先花[1] 马秀亮[2] 

机构地区：[1]天津医科大学研究生院,天津300070 [2]天津市长征医院皮肤色素科,天津300120

出　　处：《临床皮肤科杂志》2013年第8期454-457,共4页Journal of Clinical Dermatology

基　　金：天津市自然科学基金(09JCYBJC09600)资助项目

摘　　要：目的:探讨并比较儿童和成人易患白癜风的危险因素,为临床个体化干预治疗提供指导。方法:对521例白癜风门诊患者进行问卷调查,统计分析比较儿童和成人白癜风患者临床表现及各种相关发病因素。结果:儿童白癜风患者存在Ⅰ、Ⅱ级家族史的概率和并发晕痣的比例均高于成人患者。儿童患者中节段型比例较成人患者高;进展期比例在成人患者中较高。曝晒史、同形反应的发生率在两组间差异均无统计学意义,而患处瘙痒症状在成人患者中较常见,且患处瘙痒和同形反应均多见于进展期。成人白癜风患者发病前精神因素较儿童患者高。两者均伴有一定概率的自身免疫性疾病。结论:儿童较成人易患白癜风的危险因素主要表现在家族史和并发晕痣上;而成人较儿童的易患因素,更倾向于外界社会环境引发的不良精神因素及发病部位的炎症表现上。且自身免疫因素可能贯穿于儿童白癜风和成人白癜风的整个发病过程中。Objective： To evaluate and compare the risk factors predisposing principally to the development of vitiligo in children and adults in order to provide rationale for personalized invention in clinical practice. Methods： A standardized questionnaire was used to collect clinical data from 521 cases of vitiligo. Clinical manifestations and all related risk factors were analyzed and compared between children and adults. Results： A family history of vitiligo in first-degree and second-de- gree relatives and the incidence of halo nevi were higher in patients with childhood vitiligo than in adult vitiligo. The inci- dence of segmental vitiligo in children was siginifieantly higher than that in aduh patients. On the contrary, the incidence of progressive vitiligo was siginificantly higher in adult than in children. The incidence of sun exposure and Koebner＇s phe- nomenon were no significant difference between the childhood and adult patients, while the incidence of pruritus was higher in the adult vitiligo. Pruritus and Koebner＇s phenomenon were more common in progressive vitiligo. Psychological stress was often seen in adult patients prior to development of vitiligo. There was some probability for association of autoimmune diseases and vitiligo in both children and adults. Conclusion： A family history of vitiligo and halo nevi are major risk factors for de- velopment of vitiligo in children, while psychological stress and localized inflammation at vitiligo sites is seen more frequently in adult vitiligo. Autoimmune disorders can be associated with the development of vitiligo in both children and adults.

关 键 词：白癜风 儿童 成人 回顾性研究 

分 类 号：R758.41[医药卫生—皮肤病学与性病学]