泼尼松联合依那西普治疗并发坏疽性脓皮病的关节病性银屑病  

Prednisone combined with etanercept for the treatment of psoriatic arthritis accompanied by pyoderma gangrenosum

作　　者：吴超[1] 方凯[1] 晋红中[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院皮肤科,北京100730

出　　处：《临床皮肤科杂志》2016年第3期197-199,共3页Journal of Clinical Dermatology

基　　金：北京市自然科学基金(7152117)资助项目

摘　　要：报告1例关节病性银屑病并发坏疽性脓皮病。患者男,42岁。因反复全身红斑及鳞屑伴关节疼痛10年,右髋部溃疡1年就诊。免疫指标均正常,溃疡分泌物细菌及真菌培养均阴性。右髋部溃疡处皮损组织病理检查:溃疡形成,真皮浅中层毛细血管扩张、增生,部分血管壁呈纤维蛋白样变性,可见大量淋巴细胞、组织细胞及浆细胞呈弥漫性浸润,散在中性粒细胞浸润。诊断:关节病性银屑病并发坏疽性脓皮病。予口服泼尼松联合皮下注射依那西普治疗,疗效显著。右髋部溃疡愈合后原位置出现银屑病同形反应。A case of psoriatic arthritis accompanied by pyoderma gangrenosum is reported. A 42-year-old male presented with repeated erythema and scales accompanied by arthralgia for 10 years and ulcers on the right hip for 1 year. Immune tests showed normal. Bacterial and fungal cultures of the ulcer secretions were negative. Histopathologieal examination revealed ulcer formation, dilated and proliferated capillaries in the upper and middle dermis, and fibrous protein-like degeneration on vascular walls. Scat- tered neutrophilie infiltrate and diffuse infiltration of lymphoeytes, histiocytes and plasma cells were observed in the dermis. The diagnosis of psoriatic arthritis accompanied by pyoderma gangrenosum was made. Disease was markedly improved after treatment with oral prednisone combined with subcutaneous injection of etanercept. Koebner phenomenon appeared at the healed ulcer site on the right hip.

关 键 词：银屑病 关节病性 坏疽性脓皮病 同形反应 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]