11岁女孩反复全身散在皮疹10年  

Recurrent systemic sporadic rash for 10 years in a girl aged 11 years

作　　者：李珂瑶 汤建萍[1] 树叶[1] 岳淑珍 王妤娓 文容 周斌[1] LI Ke-Yao;TANG Jian-Ping;SHU Ye;YUE Shu-Zhen;WANG Yu-Wei;WEN Rong;ZHOU Bin(Department of Dermatology,Hunan Children's Hospital,Changsha 410007,China)

机构地区：[1]湖南省儿童医院皮肤科,湖南长沙410007

出　　处：《中国当代儿科杂志》2022年第9期1047-1052,共6页Chinese Journal of Contemporary Pediatrics

摘　　要：病例介绍患儿,女,11岁,因发现四肢及腔口(口周、眼周、肛周等皮肤与黏膜交界的部位)部位皮疹10年余就诊。患儿自3月龄开始出现手足关节、外阴、肛周处红斑,红斑上可见水疱、溃疡,就诊当地医院,考虑“尿布皮炎”,予鞣酸软膏及激素类乳膏(具体不详)外用,好转不明显。而后皮疹加重,并逐渐累及口周、四肢。曾多次前往广州某医院就诊,诊断考虑“肛周皮炎、湿疹”,查微量元素未见异常,但考虑患儿脱屑明显,予口服补锌及外用药物(具体不详)治疗,病情好转,但停药后复发,皮疹反复出现。患儿大小便正常,无腹泻。A girl, aged 11 years, was admitted due to recurrent rash on the whole body and mucosa for 10 years, and typical rash was erythema at the perioral region, hand-foot joints, vulva, and perianal region, with blisters, erosions, and ulcers on the erythema. The girl was improved after zinc supplementation. Her younger brother had similar rash and medical history. The histopathological examination showed epidermal parakeratosis with mild hyperkeratosis, severe spongiform edema of the stratum corneum, significant proliferation of acanthocytes, and vacuolation of keratinocytes.The genetic testing revealed that both the girl and her younger brother had a homozygous mutation of c.1456(exon9)delG in the SLC39A4 gene, and thus the girl was diagnosed with acrodermatitis enteropathica. It is concluded that for children with recurrent rash on the limbs and at the perioral region, genetic testing should be performed as early as possible to make a confirmed diagnosis, and a sufficient dose of zinc supplementation should be given, while the levels of trace elements such as blood zinc should be regularly monitored.Citaion:[Chinese Journal of Contemporary Pediatrics, 2022, 24(9): 1047-1052]

关 键 词：尿布皮炎 肛周 鞣酸软膏 眼周 散在皮疹 外用药物 激素类 微量元素 

分 类 号：R758.5[医药卫生—皮肤病学与性病学]