急性痘疮样苔藓样糠疹64例临床分析

Clinical analysis of 64 cases with pityriasis lichenoides et varioliformis acuta

目的:分析急性痘疮样苔藓样糠疹(PLEVA)临床特征和疗效。方法:对64例PLEVA患者进行回顾性分析。结果:(1)64例患者中男女发病率之比为4.3∶1;(2)29.69%的患者发病前有感染史,93.75%的患者皮损具有多形性,43.75%症状较重者出现白细胞计数、转氨酶、免疫球蛋白(IgM、IgG、IgA)等实验室检查指标异常;(3)组织病理:淋巴细胞性血管炎,淋巴细胞、红细胞游人表皮为特征;(4)糖皮质激素、窄波中波紫外线(NB-UVB)、雷公藤多苷、四环素、甘草酸二胺等联合治疗有效。结论:PLEVA临床表现多样性,治疗以糖皮质激素为主。

Objective： To analyze the clinical features and treatment of pityriasis lichenoides et variolifor-mis acuta （PLEVA）. Methods： We retrospectively analyzed the clinical and laboratory data of 64 patients di-agnosed as PLEVA. Results： （1） The ratio between male and female was 4.3 ∶1. （2） 29.69% of the patients had an infection history before the onset of the disease. Pleomorphic skin lesions, such as erythema, papules, necrosis, ulceration, et al were seen in 93.75% of the patients. The abnormal laboratory tests such as white blood cell count, aminotransferase, immunoglobulin （IgM, IgG, IgA） were seen in 43.75% of severe pa-tients. （3） The pathological examination showed lymphocytic vasculitis, migration of lymphocytes and erythro-cytes into the epidermis. （4） The treatments including glucocorticoids, NB-UVB, TWP, tetracycline and gly-cyrrhizin diamine were effective. In severe PLEVA （39.06%） glucocoriticoid had been used in a combination with other drugs. Conclusion： PLEVA has a variety of clinical manifestations and steroid is till the mainstay in the treatment.