儿童炎症性肠病50例皮肤表现分析  

Analysis of skin manifestations in 50 children with inflammatory bowel disease

作　　者：王安琪 苏静[2] 张龙[3] 姜雅楠 张娟[4] 李在玲[4] 王文慧[1] Wang Anqi;Su Jing;Zhang Long;Jiang Yanan;Zhang Juan;Li Zailing;Wang Wenhui(Department of Dermatology,Peking University Third Hospital,Beijing 100191,China;Department of Pathology,Peking University Third Hospital,Beijing 100191,China;Wound Healing Center,Peking University Third Hospital,Beijing 100191,China;Department of Pediatrics,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院皮肤科,北京100191 [2]北京大学第三医院病理科,北京100191 [3]北京大学第三医院伤口治疗中心,北京100191 [4]北京大学第三医院儿科,北京100191

出　　处：《中华皮肤科杂志》2022年第10期895-899,共5页Chinese Journal of Dermatology

基　　金：北京大学第三医院人才孵育基金(Y80446-09)。

摘　　要：目的分析儿童炎症性肠病(IBD)的皮肤表现。方法回顾性分析2010年1月至2022年1月北京大学第三医院儿科病房收治的IBD患儿的皮肤表现。结果纳入IBD患儿50例,其中27例克罗恩病,23例溃疡性结肠炎(UC)。25例(50%)患儿有皮肤表现,特异性皮肤表现和相关性皮肤表现各11例(各占22%)。特异性皮肤表现包括2例肛周皮肤克罗恩病、9例肛瘘和/或肛周脓肿;相关性皮肤表现包括5例结节性红斑、3例阿弗他口炎、1例银屑病、1例结节性多动脉炎、1例过敏性紫癜。与UC组相比,克罗恩病组更易出现特异性皮肤表现和相关性皮肤表现,两组差异有统计学意义(均P<0.05)。27例克罗恩病患儿中,19例(70%)有1种或以上皮肤表现,其中2例先后出现4种不同皮肤表现。1例克罗恩病和1例UC患儿不同时期出现过3种不同皮肤表现。有皮肤表现的患儿粪便钙卫蛋白均升高,无皮肤表现患儿中12例(48%)粪便钙卫蛋白升高。5例患儿在生物制剂调整剂量(1例)或转换(4例)后皮损好转或消退。结论半数IBD患儿有皮肤表现,克罗恩病患儿更易出现特异性和相关性皮肤表现。同一患儿不同时期可伴有不同皮肤表现。多学科团队协作有利于该病的整体控制。Objective To analyze skin manifestations of pediatric inflammatory bowel disease(IBD).Methods Children with IBD were collected from pediatric wards in Peking University Third Hospital from January 2010 to January 2022,and their skin manifestations were retrospectively analyzed.Results A total of 50 children with IBD were included,including 27 with Crohn′s disease and 23 with ulcerative colitis.Twenty-five(50%)patients had skin manifestations,including specific skin manifestations in 11(22%)and relevant skin manifestations in 11(22%).Specific skin manifestations included cutaneous perianal Crohn′s disease in 2 cases,and anal fistula and/or perianal abscess in 9 cases;relevant skin manifestations included erythema nodosum in 5 cases,aphthous stomatitis in 3 cases,psoriasis in 1 case,polyarteritis nodosa in 1 case,and Henoch-Sch?nlein purpura in 1 case.Compared with the ulcerative colitis group,the Crohn′s disease group was more prone to suffer from specific skin manifestations and relevant skin manifestations,and there were significant differences in the prevalence of specific and relevant skin manifestations between the two groups(both P<0.05).Of the 27 children with Crohn′s disease,19(70%)had one or more skin manifestations,2 of whom successively presented with 4 different skin manifestations.One child with Crohn′s disease and 1 with ulcerative colitis had 3 different skin manifestations in different periods.The fecal calprotectin level was elevated in all children with skin manifestations,and in 12(48%)children without skin manifestations.The skin lesions of 5 children were improved or subsided after dose adjustment(1 case)or switch(4 cases)of biological agents.Conclusions Half of the children with IBD have skin manifestations,and children with Crohn′s disease are more prone to have specific and relevant skin manifestations.Different skin manifestations could be observed in the same child in different periods.Multidisciplinary teamwork is conducive to the overall control of this disease.

关 键 词：炎性肠疾病 结肠炎 溃疡性 CROHN病 儿童 皮肤表现 病理过程 钙卫蛋白 

分 类 号：R725.7[医药卫生—儿科]