季节性获得性对称性色素性苔藓样肢端角化病31例临床分析

Clinical Analysis of 31 Patients with Seasonal Acquired Symmetric Pigmentary and Lichenoid Acrokeratoderma

目的对31例季节性获得性对称性色素性苔藓样肢端角化病患者进行临床分析,归纳总结其临床特点.方法追踪随访并收集南方医科大学附属深圳龙华人民医院皮肤科门诊2006年3月至2012年11月31例患者临床资料,采用描述性方法来总结.结果 31例患者中男28例,女3例,平均年龄27.3岁,平均发病年龄21.6岁.通常春末夏初发病或复发,夏季加重,秋末冬初减轻或消失;皮损主要对称性分布于手腕、手背、踝部、膝部、足背、肘部、指蹼、手侧缘、肘窝,表现为色素性苔藓样斑片或斑块,无明显不适;真菌学检查阴性;组织病理学表现为表皮角化过度和乳头瘤样增生.结论 31例患者的临床表现比较独特,此病是新出现的一种皮肤病,皮肤科医生应予以重视.

Objective To analyze the clinical data of 31 patients with seasonal acquired symmetric pigmentary and lichenoid acrokeratoderma （SASPLA） and summarize its clinical features. Methods Thirty-one dermatologic outpatients in our hospital from March 2006 to November 2012 were followed up and their clinical data were collected and analyzed in the present study. Results There were 28 male and 3 female patients among these 31 patients. The mean age was 27.3 years old and the age at onset was 21.6 years old. Lesions usually occurred or relapsed in the end of spring or the beginning of summer, aggravated in summer, and vanished or alleviated in the end of autumn or the beginning of winter. The lesions usually symmetrically distributed on the skin of wrists, the back of hands, ankles, knees, dorsum of feet, elbows, fingerwebs, lateral margin of hands and triangles of elbow. All lesions were pigmentary, lichenoid, hyperkeratotic patches or plaques and without noticeable discomfort. Fungi tests were negative. The histopathology revealed hyperkeratosis and papillomatosis of the epidermis. Conclusion The characteristics of the present 31 patients are distinct. This is a new dermatosis to which dermatologist should pay more attention.