儿童泛发性脓疱型银屑病23例临床分析

AnAnalysisof23InpatientswithGeneralizedPustularPsoriasisinChildren

儿童泛发性脓疱型银屑病（ＧＰＰ）临床上较为少见。现分析了２３例住院儿童ＧＰＰ，男１６例，女７例；年龄２～１２岁，平均７．３５岁。临床观察表明，上呼吸道感染及不规则使用皮质类固醇激素治疗，是ＧＰＰ诱发和加重的重要因素。雷公藤、氨苯砜、红霉素联合应用对ＧＰＰ具有协同疗效，治疗２０例患儿，１～２周内治愈率达３５％，总有效率为８０％，可作为首选治疗方案；Ｔｉｇａｓｏｎ、甲氨喋呤作为二线药物选用；皮质类固醇激素不推荐为常规治疗药物。患儿年龄、原发病及治疗选择对预后具有一定影响。

Generalizedpustularpsoriasis(GPP)inchildrenisrare.Twenty-threeinpatientswithGPPinchildren(16malesand7females,agerangedfrom2to12years,withanaverageof7.35years)wereanalyzed.Clinicalobservationrevealedthatupperrespiratorytractinfectionandirregularcorticosteroidtherapywereimportantfactorsininducingandaggravatingthedisease.TwentypatientsweretreatedwithacombinationofLeigongteng(Tripterygiumwilfordi),dapsoneanderythromycin,7ofthem(35%)cured,9(45%)improvedin1～2weeks.Itistheauthor′sopinionthattheaboveregi-menisthefirstchoiceoftreatmentforGPP,andtigason、methotrexatearethealternatives,whilecorti-costeroidsarenotrecommendedastheroutinetherapeuticdrugs.Thechildren′sage,underlyingdis-easeandtherapeuticregimenhaveefectonprognosisofthedisease.