泛发性脓疱型银屑病38例临床分析

Clinical analysis of 38 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，以提高诊疗水平。方法回顾性分析38例GPP患者的临床资料及治疗过程。结果多种因素可导致GPP发病，感染及不规则使用皮质类固醇激素治疗是GPP诱发或加重的重要因素，发热、红斑、脓疱是其主要临床表现。雷公藤联合阿维A治疗有效率达93．3％，环孢素单独治疗有效率为75．0％。结论感染为GPP最常见诱因，应以维A酸和免疫抑制剂为一线药物，不推荐糖皮质激素作为常规一线治疗药物。

Objective To analyze the etiological factor, clinical situation, and therapeutic effect of generalized pustular psoriasis （GPP） and to promote the level of diagnosis and treatment for GPP. Methods The clinical data of 38 patients with GPP were retrospectively analyzed. Results The inducing factors for the onset of GPP were multiple - - in which infection and irregular use of systemic corticosteroids were the main causes. The main clinical representation was fever, redness, and pustules. The treatment efficacy was 93.3% for Tripterygium wilfordii combined with acitretin and 75.0% for cyclosporin. Conclusion The most common cause of GPP is infection. The retinoic acids and the immune depressants are the first choice agents for the treatment of GPP. Corticosteroids are not recommended as the first - line drugs for GPP.