疱疹样脓疱病的临床特征

Clinical Characteristics of Impetigo Herpetiformis in 14 Patients

目的探讨疱疹样脓疱病(impetigo herpetiformis,IH)的临床特点、诊断和治疗方法。方法回顾性分析1983年3月至2012年3月间北京协和医院皮肤科收治的14例IH住院患者的临床表现、实验室检查和组织病理检查结果、治疗方法及预后。结果本组患者临床表现、实验室检查和组织病理检查符合IH的典型表现。14例患者中,妊娠中期首次发病者有7例(50%),妊娠晚期发病者4例(28.6%)。11例(78.6%)患者出现低钙血症。6例(42.9%)患者接受系统性糖皮质激素、雷公藤多甙或阿维A中任一药物治疗且反应较好,8例(57.1%)患者接受系统性糖皮质激素联合甲氨蝶呤和/或阿维A治疗后方取得较好效果。结论 IH在不同人群中首次发病时所处的妊娠时期可能存在一定差异。病情较重的患者对系统性糖皮质激素治疗反应差,需联合其他药物治疗以获得较好疗效。

Objective To summarize the clinical characteristics of impetigo herpetiformis （IH）. Methods The clinical and laboratory data of 14 IH patients who were treated in our department from March 1983 to March 2012 were analyzed retrospectively. Results All these patients met the diagnostic criteria of IH. Of these 14 patients, 7 （50%） experienced the first onset of IH during the second trimester of pregnancy and 4 （28.6%） during the third trimester. Eleven patients （78.6%） also suffered from hypocalcemia. Six （42.9%） responded well to a monotherapy of systemic corticosteroids, tripterygium glycosides, or acitretin. Eight （57.1% ） were treated effectively after a combination therapy using systemic corticosteroids with methotrexate and （or） acitretin. Conclusions The trimesters of pregnancy in which the first onset of IH occurs may vary in different populations. Patients with severe IH have poor response to monotherapy and therefore require the application of a combination therapy with other drugs to control the condition.