伊曲康唑口服液治愈婴儿血管瘤1例:皮肤镜监测血管瘤消退情况  

A Case of Infantile Hemangioma Successfully Treated by Itraconazole Oral Solution: Dermoscopy Monitory the Vascular Regression

作　　者：冉玉平[1] 徐小茜[1] 冉昕[1] 庄凯文[1] 陈爽[1] 穆潺[1] 冯孝伟 孙凯奕 唐教清[1] 杨琴[1] RAN Yu-ping XU Xiao-xi RAN Xin ZHUANG Kai-wen CHEN Shuang MU Chan FENG Xiao-wei SUN Kai-yi TANG Jiao-qing YANG Qin(Department of Dermatology, West China Hospital,Sichuan University, Chengdu 610041, China)

机构地区：[1]四川大学华西医院皮肤性病科,四川成都610041

出　　处：《中国皮肤性病学杂志》2017年第1期45-47,49,共4页The Chinese Journal of Dermatovenereology

基　　金：国家自然科学基金面上项目(81472539)

摘　　要：患儿女,3个月,出生后第10天右腹部发现4个针尖大小红色丘疹,体积逐渐增加至6mm×4mm×1.6mm(彩超测定皮损体积),色鲜红,皮肤镜下可见线团块分布的血管网。予以马来酸噻吗洛尔滴眼液局部湿敷(2次/d,每次1小时,每次约0.5m L),3个多月后瘤体仍扩大融合并隆起,皮肤镜下血管网簇集成团,边缘可见向外延伸的血管分支,提示仍有扩大趋势。更改治疗为伊曲康唑口服液内服[5mg/(kg·d)],治疗期间皮损颜色逐渐变暗,表面出现裂隙凹陷和皱纹,使之分成小叶状,皮肤镜下血管网变模糊,血管数量逐渐减少。治疗68天后(口服总量约2300 mg)临床及皮肤镜可观察到血管瘤有明显消退迹象遂停药随访。4月后血管瘤基本消退,残留少许纤维脂肪组织印迹。服药期间患儿肝肾功能在正常范围内,未见不适。伊曲康唑口服液治疗婴幼儿血管瘤服药方法简单方便,患儿及家属依从性好,治疗效果满意。皮肤镜在原位精准观察治疗过程血管瘤变化情况中起重要作用。A 3-mouth girl presented with 4 little red dots on her abdomen 10 days after birth and the lesion kept growing to 6mm × 4mm × 1.6 mm （ volume evaluated by color Doppler ultrasound performance）. The lesion was brightly-red and linear and cloddy vascular network was seen under dermoscopy. Topical dressing of 0. 5% timolol maleate eyedrop, 0. 5 mL, 1 hours each time, twice a day was initial treatment. After 3 months of follow up, the lesion became bigger, dermoscopy observed more intensive vascular network and outward capillary branches which were the hints of growing trend. Administration of itraconazole oral solution was then altered for therapy with a dosage of 5 mg/kg/d. During the treatment, the lesion became darker, small cracks and wrinkles appeared on the surface which divided the lesion into lobules. Dermotoscopic feature showed instinct vascular network and less capillary branches. After 68 days of oral itraconazole solution （ the total dose was about 2300 mg） the lesion was seen degrading obviously, then the treatment ended. The lesion was almost cured with little fibrofatty tissue left at the next 4 months of follow up. In the course of oral itraconazole, the patient＇ s hepatic and renal function remained normal and no adverse react was observed. Itraconazole oral solution to treat infantile hemangioma was simple and easy to operate. The baby patient and parents showed good compliance and the clinical outcome demonstrated its efficacy. Dermotoscopy played a key role in vivo accurate observation of the hemangioma changes with vascular regression during the treatment process.

关 键 词：婴幼儿血管瘤 伊曲康唑口服液 噻吗洛尔 皮肤镜 

分 类 号：R732.2[医药卫生—肿瘤]