泛发性脓疱型银屑病92例临床分析

Clinical Analysis of 92 cases of Generalized Pustular Psoriasis

目的探讨泛发性脓疱型银屑病(GPP)的诱发因素、临床特征及治疗效果,以提高临床诊疗水平。方法对2004年12月-2010年12月天津市长征医院皮肤科确诊为GPP患者的临床资料进行回顾性分析。结果①女性平均发病年龄(36.66±17.40)岁早于男性(41.53±17.47)岁;有银屑病史的GPP患者(GPPPSO+)的平均发病年龄(36.70±4.00)岁早于无银屑病史的GPP患者(GPPPSO-),(40.88±2.04)岁。②70.00%未成年GPP由感染引起,29例成年GPP多由不当应用激素引起,GPPPSO+患者中有69例由寻常性银屑病转化为本病,但GPPPSO-患者中仅有23例;GPP患者伴发肝损害16例,春夏季多发,秋冬季少。③糖皮质激素治疗组复发率高于非糖皮质激素治疗组(P=0.035)。结论感染为GPP最常见诱因,糖皮质激素不推荐为一线治疗方案。

Objective To analyse the etiological factor,clinical situation and the therapeutic effect of generalized pustular psoriasis（GPP） and to promote the clinical level of diagnosis and therapy.Methods Retrospective studies was used to analysed the various of 92 patients with GPP from the Dec.of 2004 to Dec.of 2010 in the Dermatology of Long March.Results ① Women with an average age of onset（36.66±17.40） years earlier than males（41.53±17.47） years;GPPpso＋ average age of onset（36.70±4.00） years earlier than GPPpso-（40.88±2.04） years.② 70.00% of minor GPP patients caused by infection,33 cases of adult GPP patients caused by the improper use of corticosteroid,69 cases of GPPpso＋ patient were transformed by psoriasis vulgaris,but GPPpso-patients only 23 cases;GPP patients associated with liver damage were 16 cases,more in spring and summer,less in autumn and winter.③ The recurrence rate was higher in the corticosteroid group than that in the non-corticosteroid group.Conclusion The most common causes of GPP is infection,it suggested that appropriate drug therapy should be chosen based on the disease severity.