对称性肢端角化病62例临床分析

Clinical analysis of 62 cases of symmetric acral keratoderma

目的分析对称性肢端角化病患者的临床表现、人口学资料、组织病理学特点。方法收集2003年5月以来在我院门诊就诊的对称性肢端角化病患者62例，详细了解其人口学资料及家族史，并进行全身体格检查，部分患者行皮损组织病理检查。结果62例患者中男55例，女7例，发病年龄4．53岁，平均年龄24．02岁；病程15d至10年，平均为26．65个月；主要临床表现为对称性褐色角化性斑片，皮损接触水后变白，主要分布在指背、手背、手腕、掌侧缘、踝部、膝部、肘部，冬季自然缓解；真菌检查阴性；组织病理学表现为表皮角化过度，棘层增厚，轻度乳头瘤样增生，真皮少量淋巴细胞。结论对称性肢端角化病以对称性肢端角化为主要临床表现，伴有明显季节性变化。

Objective To analyze the clinical, demographic and pathologic features of symmetric acral keratoderma. Methods Totally, 62 outpatients with symmetric acral keratoderma were collected at the Dongguan Hospital for Chronic Disease Prevention and Control from May 2003 to June 2012. Data on these patients, including demographic information, family history, physical and pathological examination findings, were reviewed. Results There were 55 males and 7 females among these patients. The age at onset and disease duration varied from 4 to 53 years （average： 24.02 years） and from 15 days to 10 years （average： 26.65 years） respectively. Characterized manifestation was brown keratinized patches on the dorsum of hands and digits, wrists, elbows, knees, ankles, and along the lateral margin of palms, which became white 3 to 6 minutes after immersing in water. Lesions usually resolved spontaneously in winter. Microscopic examination of lesions for fungal elements was negative. Histopathology revealed epidermal hyperkeratosis, acanthosis and mild papillomatous hyperplasia as well as dermal infiltrates with a few lymphocytes. Conclusion Symmetric aeral keratoderma is a skin disease characterized by sym- metric acral keratosis with apparent seasonality.