| 刘 齐,李 瑾,沈 波,莫小辉,郭 敏,郭 怡,谭 飞.对称性肢端角化病临床研究-附9例报道[J].,2018,(8):1556-1559 |
| 对称性肢端角化病临床研究-附9例报道 |
| The Clinical Research of Symmetric Acral keratoderma: Nine Cases |
| 投稿时间：2017-11-25 修订日期：2018-01-07 |
| DOI：10.13241/j.cnki.pmb.2018.08.033 |
| 中文关键词: 对称性肢端角化 寻常型鱼鳞病 异维A酸 |
| 英文关键词: Symmetrical acrokeratoderma Ichthyosis vulgaris Acitretin |
| 基金项目:国家自然科学基金项目（81502738）；上海市科委项目（15ZR1436900）；上海卫计委重点学科项目（12GWZX0902） |
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| 中文摘要: |
| 摘要 目的：报道一组以肢端出现对称性、棕褐色、角化过度性斑片病例，探讨发病原因和治疗方法。方法：系统收集自2012年10月至2016年6月期间诊疗的以对称性肢端角化性皮损为表现的9例患者的临床资料,包括年龄、性别、职业、家族成员情况、临床表现、皮损组织病理学改变、治疗、治疗转归等。结果：9例患者中男8例，女1例，平均年龄27.4岁（13～43岁），病程2个月至15年,平均(4.5±4.3)年。有1例男性患者有一同胞姐姐有类似病史。临床主要表现为红褐色角化性斑片，每年7、8月开始发病，10月左右开始缓解并渐完全消退。部分手部有轻度瘙痒不适。皮肤组织病理学检查表现为明显的网篮状角化过度，轻度乳头瘤样增生，真皮浅层血管周围稀疏淋巴细胞浸润。1例用异维A酸治疗短期有效。结论：对称性肢端角化病主要以肢端出现对称性角化斑为主,常伴随寻常型鱼鳞病；遗传因素和环境因素在发病中的作用有待阐述；异维A酸可作为一种治疗选择。 |
| 英文摘要: |
| ABSTRACT Objective: To report nine patients who presented symmetric keratosis on the acral extremities and to investigate the clinic opathologic features, denomination, aetiological agent and therapeutic method. Methods: Nine patients characterized by symmetrical acrokeratoderma were collected from outpatients from October 2012 to June 2016 in the Department of Dermatology. General information on the age, sex, profession, family history of patients were documented. All patients underwent clinical and histopathological examinations and were followed up for the assessment of treatment efficiency. Results: Among these patients, 8 were males and 1 were females, ranging in age from 13 to 43 years, with duration of disease varying from 2 months to 5 years(mean course 1.5±1.2 years). A man and his sister had the similar disease history. All 9 patients had brownish-black plaques distributed symmetrically over dorsum of hand and feet with variable involvement of wrist, flexural surface of ankles, elbow, shin and knee joint. Typically whitish maceration of the lesions was seen after immersing in water. The disease showed exacerbation in July with spontaneous resolution in October. Histopathological examination showed basket weave hyperkeratosis, papilloma hyperplasia，irregular acanthosis and papillary dermal perivascular infiltrate of lymphohistiocytes. Isotretinoin appeared to provide symptomatic improvement in the short term for one case. Conclusion: Symmetric acral keratoderma may represent a new entity clinically characterized by symmetrical acrokeratoderma. This disorder is frequently associated with ichthyosis vulgaris. The genetic and environmental factors involved in disease causation needs to be elucidated in future. Isotretinoin is a choose for therapy. |
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