白塞病37例临床误诊分析  

Clinical Analysis of 37 Misdiagnosed Cases of Behcet's Disease

作　　者：尹逊国[1] 卢凤艳[1] 余妍欣 乔娜[1] 李冬青[1] 郑江涛[1] 

机构地区：[1]云南省曲靖第一人民医院(昆明医科大学附属曲靖医院)皮肤科,云南曲靖655000

出　　处：《中国皮肤性病学杂志》2017年第10期1155-1156,1168,共3页The Chinese Journal of Dermatovenereology

摘　　要：目的分析37例白塞病误诊的原因,加深临床医师对本病的认识。方法收集本科2009年1月-2015年12月曾经误诊的白塞病37例,对其临床表现、误诊的疾病和科室进行原因分析。诊断标准采用2014年白塞病的国际标准评分系统。结果临床表现中,口腔溃疡37例(100%),结节性红斑18例(48.65%),针刺反应阳性22例(59.46%),生殖器溃疡9例(24.32%),眼部病变15例(40.54%),关节疼痛13例(35.13%),毛囊炎13例(35.13%),紫癜样皮损2例(5.40%),多形红斑样皮损和神经病变各1例(2.70%)。误诊为结节性红斑15例(40.54%),阿弗他溃疡9例(24.32%),巩膜炎及结膜炎6例(16.22%),外阴溃疡2例(5.40%),固定性药疹2(5.40%);复发性生殖器疱疹、过敏性紫癜1例和脑梗死各1例(2.70%)。结论白塞病临床表现多样,因首发症状不一而就诊科室不同;本病的诊断没有特异性的血清学诊断,所以需要综合考虑,避免临床上误诊或漏诊。Objective To analyze the reason of misdiagnosis of 37 cases of Behcet＇s disease,so that clinicians can enhauce the understanding of the disease.Methods Thirty-seven cases of patients with Behcet＇s disease from January 2009 to December 2015 were misdiagnosed.The gender,age,clinical manifestations and treatment departments were analyzed.The diagnostic criteria is the 2014 international standard scoring system of Behcet＇s disease.Results Clinical manifestations：There were 37 cases（100%）of oral ulceration,18 cases（48.65%）of erythema erythema,22 cases（59.46%）of positive reaction of acupuncture,9 cases（24.32%）of genital ulcer,15 cases（40.54%）of ocular lesions,13 cases（35.13%）of joint pain,13 cases（35.1%）of folliculitis,2 cases（5.40%）of purpura like lesion,1 cases（2.70%）of erythema like lesion,1 cases（2.70%）of neuropathy.15 cases（40.54%）were misdiagnosed as erythema nodosum,9 cases（24.32%）as aphthous ulcer,6 cases（16.22%）as scleritis and conjunctivitis,2 cases（5.40%）as ulcer of vulva,1 cases（2.70%）as recurrent genital herpes,2 cases（5.40%）as fixed drug eruption,1 cases（2.70%）as allergic purpura,1 cases（2.70%）as cerebral infarction.Conclusion The clinical manifestations of Behcet＇s disease are various,involving various systems. The first medical department is not same,no specific serological diagnosis for the diagnosis. Therefore,it needs to be analysed in clinic.

关 键 词：白塞氏病 误诊 

分 类 号：R597.9[医药卫生—内科学]