五例角层下脓疱病治疗体会  

Therapy of 5 cases of subcorneal pustular dermatosis

作　　者：姜红浩 田庆均[1] 赵芬[1] 范昉[1] 周小勇[1] JIANG Hong-hao;TIAN Qing-jun;ZHAO Fen(Department of Dermatology,Wuhan No.1 Hospital,Wuhan 430022,China)

机构地区：[1]武汉市第一医院皮肤科

出　　处：《实用皮肤病学杂志》2019年第6期373-375,共3页Journal of Practical Dermatology

摘　　要：5例角层下脓疱病患者,皮损均表现为红斑基础上的浅表脓疱,部分排列呈环形。组织病理均显示角层下脓疱及中性粒细胞聚集;直接免疫荧光检查阴性。其中4例患者于发病早期系统应用糖皮质激素取得较好疗效,但糖皮质激素减量或停药时,皮损反复并加重,再次使用糖皮质激素出现治疗抵抗;3例患者联合阿维A胶囊、1例患者联合环孢素和秋水仙碱治疗后,皮损完全缓解;1例患者经柳氮磺吡啶治疗后皮损大部分缓解。随访1年,5例患者均需维持治疗。角层下脓疱病病因复杂,自身免疫紊乱、病毒感染及血液系统疾病可能参与5例患者的发病,而阿维A及柳氮磺吡啶较糖皮质激素更适合病情的长期控制。We report 5 cases of subcorneal pustular dermatosis(SPD).Patients presented with superficial pustules based on the erythema,and sometimes in annular patterns.The histopathology examination identified subcorneal pustules filled with polymorphonuclear leukocytes,and the direct immunofluorescence results were negative.Four patients were successfully treated by glucocorticoids in the initial stage.However,the disease relapsed and aggravated when glucocorticoids were reduced or discontinued.Treatment resistance occured when glucocorticoids were tried again.With glucocorticoids gradually reduced,three patients were later treated with acitretin and 1 patient with cyclosporine plus colchicin,and the lesions completely regressed.The other patient was mostly improved after treated with sulfasalazine.During one year follow-up,all 5 patients needed maintenance therapy.The pathogenesis of SPD is complicated,and autoimmune disorders,viral infections and hematological disorders may be involved in these five patients.Acitretin and sulfasalazine are more suitable for longterm control of this relapsing disease when compared with glucocorticoids.

关 键 词：角层下脓疱病 治疗 

分 类 号：R758.74[医药卫生—皮肤病学与性病学]