脓疱性银屑病76例临床分析

Clinical analysis of 76 cases of pustular psoriasis

目的:分析脓疱性银屑病的临床特征。方法:对76例脓疱性银屑病患者按照国际上通行的分类方法进行诊断和分类,并对其病史资料、临床特征和治疗经过进行分析。结果:该76例脓疱性银屑病在同期就诊的银屑病患者中占8.6%,其中以局限性居多,占71.0%,主要累及掌跖部位;泛发性病例中5种临床亚型均各有2～6例患者,表现为程度不一的红斑、脓疱和鳞屑。根据不同的皮疹特点给予窄谱中波紫外线(NB-UVB)、长波紫外线(UVA)、维A酸等综合治疗取得较为满意的效果,有效率为49.2%。结论:脓疱性银屑病的临床表现和治疗反应在不同患者间差异较大。新的分类方法对指导临床实践具有积极意义。

Objective: To define the clinical features of pustular psoriasis (PP). Methods: Patients with pustular psoriasis were recruited to this study from September 2002 to December 2003. The diagnosis and classification were made according to the currently widely accepted criteria. Their clinical characteristics, histological features and treatment course were analyzed. Results: Patients with pustular psoriasis accounted for 8.6% (n=76) of all psoriatic patients seeking medical advice in the above interval. Within pustular psoriasis, the localized PP was the most common form which mainly affected the palm and sole. There were 2 to 6 cases in each five different forms of generalized PP which manifested mainly as erythema, pustule and scale in different degree. Most of the patients responded very well to the treatments with NB-UVB, UVA, retinoids or other therapeutic alliance. Total response rate was 49.2%. Conclusion: The clinical manifestations and treatment response of pustular psoriasis vary greatly in different patients. The new classifying method is useful and helpful in the clinical management of the disease.