红皮病128例临床分析

Clinical Analysis of 128 Patients with Erythroderma

目的探讨红皮病的病因、预后及其影响因素。方法回顾性分析了128例红皮病的临床资料。结果128例患者 ,男女之比2.9∶1 ,平均发病年龄52.4岁。71.1 %继发于原有皮肤病 ,其中银屑病所致者占48.4 % ,12.5 %为药物过敏 ,5.5 %继发于恶性肿瘤 ,10.9 %病因不明。不合理治疗(34.4 %)是诱发和加重红皮病的主要因素。随访的85例患者中 ,4例死于皮质类固醇和免疫抑制剂应用导致的并发症 ,3例死于恶性肿瘤。结论原因不明的红皮病大多与潜在肿瘤、药物过敏有关。红皮病的预后取决于致病原因、并发症及治疗方法 ,药物过敏引起的红皮病预后最好 ,银屑病性红皮病易反复发作。

Objective To study the causes of erythroderma, the prognosis of patients and the influencing factors. Methods Clinical data from 128 cases of erythroderma were retrospectively analyzed. Results The male female ratio was 2.9∶1. The mean age of onset was 52.4 years old. The most frequent cause of erythroderma was the exacerbation of a preexisting dermatosis (71.1%),among them patients with psoriasis accounted for 48.4%; followed by drug reactions(12.5%); malignancies and unknown origin accounted for 5.5%and 10.9%, respectively. The inappropriate treatments(34.4%) were the main factor in inducing and aggravating erythroderma. Follow up data were obtained from 85 patients (66.4%). In seven of the patients who died, four cases were related to erythroderma, three died of malignancies.Conclusion Erythroderma of unknown origin is mostly related to insidious malignancies and drug reactions. The prognosis of the disease depends on the causes and complications of erythroderma and therapeutic regimens. Erythroderma caused by psoriasis is prone to recur while the prognosis of drug reaction related erythroderma is excellent.