儿童持久性隆起性红斑

Pediatric Erythema Elevatum Diutinum

持久性隆起性红斑是一种罕见的嗜中性皮病,以紫罗兰色或红褐色丘疹、斑块及结节为典型临床表现。最常发生于成人,儿童少见。感染因素、血液系统疾病及肿瘤、自身炎症和免疫性疾病与该病相关;也可伴有关节痛、眼部损害、神经病变等皮肤外症状。疾病诊断需要结合临床特征和组织病理学改变。氨苯砜是治疗疾病的一线药物,糖皮质激素、磺胺类、秋水仙碱、吗替麦考酚酯、环孢素、硫唑嘌呤、四环素等可作为二线或替代药物,对于局限的晚期皮损,可采用手术切除。本文回顾分析了既往儿童EED的病例,结果显示10岁及以下的患者占大多数,皮损表现和成人临床表现类似,氨苯砜仍是作为一线治疗药物。

Erythema elevatum diutinum(EED) is a rare neutrophilic dermatosis characterized by violet or reddish brown papules, plaques and nodules. It commonly occurs in adults, and rarely in children. Infection, hematopoietic system disease, autoinflammatory and immune diseases are related to the disease. It can also be accompanied by extracutaneous symptoms such as arthralgia, eye damage, neuropathy. The diagnosis needs to be based on clinical features and histopathological changes. Daphne is the first-line therapy. Glucocorticoids, sulfonamides, colchicine, mycophenolate mofetil, cyclosporine, azathioprine, tetracycline, can be used as second-line or alternative drugs. The focal late lesions can be removed by surgical resection. This article also reviewed the previously reported cases of children with EED. The results showed that the patients under 10-year-old were in the majority with the similar clinical manifestations of adults′ patients, and dapsone was still the first-line treatment.