有结节性红斑表现的强直性脊柱炎10例并文献复习  

Ankylosing Spondylitis Complicated with Erythema Nodosum: 10 Cases Report with Literature Review

作　　者：许夏雨 邓肇达 刘媛媛[2] 张莉[2] 沈海丽[2] 

机构地区：[1]兰州大学第二临床医学院,甘肃兰州730030 [2]兰州大学第二医院风湿免疫科,甘肃兰州730030

出　　处：《中国皮肤性病学杂志》2017年第7期749-750,共2页The Chinese Journal of Dermatovenereology

基　　金：甘肃省卫生行业科研计划管理项目(GWGL2014-47);国家自然科学基金(81560267);兰州大学第二医院院内课题(ynbskyjj2015-1-14)

摘　　要：目的提高结节性红斑(EN)与强直性脊柱炎(AS)相关性的关注。方法收集10例伴有EN表现的AS患者的临床资料,对其临床表现、实验室及辅助检查结果进行分析。结果 10例患者中,男性4例,女性6例,平均年龄(35±8)岁,病程6个月~30年。红斑部位多见于小腿伸侧,伴或不伴有外周关节炎/关节痛,受累关节主要为下肢大关节;6例有腰背痛,1例有趾炎,5例有足跟痛,3例有口腔溃疡,5例HLA-B27阳性,3例ESR和5例CRP水平升高,骶髂关节X片或CT双侧II级9例,骶髂关节X片单侧III级1例。结论对有EN表现,排除感染、结缔组织病等常见病因后,当患者表现有一种或一种以上脊柱关节炎(SpA)的临床表现或HLA-B27阳性,应筛查SpA相关检查,警惕隐匿性AS存在。Objective To raise awareness of the correlation between erythema nodosum（EN）and ankylosing spondylitis（AS）. Methods Data on the clinical characteristics of 10 patients with AS accompanied by EN were collected. Their clinical manifestations, laboratory results, and supplemental examination results were analyzed. Results Of the 10 patients, 4 were men and 6 were women. The mean age was 35 ± 8 years, and the period of illness ranged from 6 months to 30 years. Erythema was most frequently observed on the extensor surface of the lower leg, with or without accompanying peripheral arthritis/arthralgia. Affected joints were primarily the large joints of the lower extremities. Six patients had lower back pain, 1 patient had paronychia, 5 patients had heel pain, and 3 patients had oral ulcers. Five patients tested positive for HLA-B27, 3 patients had elevated erythrocyte sedimentation rate（ESR）, and 5 patients had elevated C-reactive protein levels. Nine patients had bilateral level II sacroiliac joints on radiography or computed tomography examination, and 1 patient had a unilateral level III sacroiliac joint on radiographic examination. Conclusion Upon presentation of EN after elimination of common etiologies such as infection and connective tissue disease, patients who present with one or more clinical manifestations of spondyloarthritis（SpA）or tested positive for HLA-B27 should be screened with SpA examination to reveal potentially hidden AS.

关 键 词：结节性红斑 强直性脊柱炎 

分 类 号：R758.61[医药卫生—皮肤病学与性病学] R593.23[医药卫生—临床医学]