Riehl黑变病患者心理状态初步分析

A pilot study of psychological state in Riehl's melanosis

目的:观察Riehl黑变病患者心理因素在发病中的作用。方法:我院皮肤科门诊29例黑变病患者入选。记录患者一般情况、致病因素、治疗经过、疾病进展情况。采用症状自评量表(Symptom Checklist90,SCL-90)、抑郁自评量表(self-depression scale,SDS)以及焦虑自评量表(self-ratinganxiety scale,SAS)评价患者心理状况。结果:Riehl黑变病可能的病因包括曝晒、抑郁或焦虑、接触石油化工产品、长期使用某些药物等。病变累及面部所有区域,亦可累及前胸、后背、上肢及指甲。患者自评量表SCL-90、SDS和SAS的阳性率分别为39.13%、88.46%和73.08%,其中发病前自觉紧张或繁忙的15例黑变病患者(有心理因素诱因者)的SCL-90躯体化和强迫症状因子分值显著高于常模组分值(P<0.05)。结论:心理应激可能在Riehl黑变病发病中起作用。

Objective To observe the role of psychological factors in the pathogenesis of Riehl＇s melanosis. Methods Twenty-nine Riehl＇s melanosis outpatients were enrolled in our study.The general information, etiological factors, therapeutic history and the progression of disease were recorded by a well trained dermatologist.Symptom Checklist 90 （SCL-90）,self-depression scale （SDS） and self-rating anxiety scale （SAS） were employed to evaluate the psychological condition of the patients. Results The possible etiological factors of Riehl＇s melanosis included sun exposure, depression or anxiety,contact of petrochemical products, long-term use of some medicines and so on.The total face as well as prothorax, back,upper extremity and nails of fingers were involved.The positive rates of SCL-90,SDS and SAS were 39.13%,88.46% and 73.08%,respectively.The scores of SCL-90 somatization symptom and obsessive-compulsive symptom of 15 patients who felt nervous or busy （identified as having psychological incentives） before onset were obviously higher than the score of Chinese Norm （P0.05）. Conclusion Psychological factors may play a role in the pathogenesis of Riehl＇s melanosis.