肿胀性红斑狼疮19例病例分析及文献回顾  

Lupus erythematosus tumidus:19 cases report and literature review

作　　者：史冬梅[1,2] 严红霞[1] 贾虹 

机构地区：[1]济宁市第一人民医院皮肤科,济宁272001 [2]中国医学科学院皮肤病医院

出　　处：《实用皮肤病学杂志》2015年第5期332-335,共4页Journal of Practical Dermatology

摘　　要：目的探讨我国肿胀性红斑狼疮患者的临床表现、组织病理特点、治疗以及预后,以提高对本病的认识。方法收集2009—2014年笔者确诊的6例肿胀性红斑狼疮及自2003年中国报道的13例患者的临床资料,并进行回顾性总结分析。结果 19例患者中女9例,男10例;平均发病年龄38.1岁。临床特点主要为曝光部位出现水肿性红斑,少数发生在腰背部等非曝光部位。2例患者伴有脱发。组织病理主要表现为真皮全层的血管附属器周围淋巴细胞浸润及纤维束之间的黏蛋白沉积。羟氯喹及联合糖皮质激素口服治疗有效。结论肿胀性红斑狼疮是慢性皮肤型红斑狼疮的一个亚型,临床表现相对单一,没有统一诊断标准,目前对该病的认识不足,导致患者病情迁徙、误诊、误治。因此有必要提高对该病的认识,以便给予患者正确的诊断及有效的治疗。Objective To explore the clinical and pathologic character,treatment strategy and prognoses of lupus erythematosus tumidus（LET）. Method Six cases of LET diagnosed by the author,from 2009 to 2014,as well as other 13 cases reported in China were collected,and the clinical and pathological data were analysed（the other 4 patients unable to track the details were excluded in this retrospective analysis）. Results There were 9 males and 10 females among the 19 patients with TC who were aged from 19 to 58 years（mean age： 38.1 years）. Clinically,the skin lesions mainly presented on the sun-exposed areas,minority of the skin lesions were distributed on the un-sun-exposed areas. There were 2 cases complicated with alopecia. Histopathology features include：lymphocytic,perivascular and periadnexal infiltrate with abundant interstitial,superficial,and deep dermal mucin deposition without appreciable epidermal and vacuolar changes. Typically,LET is responsive to the treatment of systemic antimalarials. Conclusion LET is a special form of chronic cutaneous lupus erythematosus. The clinical manifestation of LET is relatively special and has no unifi ed diagnostic criteria. The lack of understanding of the disease led to the misdiagnosis and deferment of the symptoms in patients. It is necessary to improve the understanding of LET,so as to give the correct diagnosis and effective treatment.

关 键 词：红斑狼疮 肿胀性 羟氯喹 

分 类 号：R593.241[医药卫生—内科学]