17例获得性反应性穿通性胶原病临床分析

Clinical analysis of 17 patients with acquired reactive perforating collagenosis

对我科17例获得性反应性穿通性胶原病(ARPC)病例的临床资料进行回顾性分析。其中男8例,女9例,年龄19～81岁,平均(51.06±16.82)岁。病程1周～5年,平均(9.54±0.56)个月。8例患者患有糖尿病,7例高血压、5例慢性肾衰。皮疹对称分布,好发于躯干(82.35%)、双下肢(76.47%),头面部少见,瘙痒明显,可见同形反应。典型皮疹为黄豆大红色丘疹,中央脐凹,内含黄色角栓,不易抠除。病理可见表皮盘状下陷,卷曲、断裂的胶原纤维束垂直穿出表皮。治疗以止痒为主,并控制系统疾病。8例患者自觉瘙痒缓解,皮疹好转,4例患者病情无明显变化,4例有明显新发皮疹。1例在确诊ARPC后1周因心力衰竭死亡。

The clinical features of 17 patients with acquired reactive perforating collagenosis(ARPC)in our department were analyzed retrospectively.There were 8 males and 9 females.The average age was 51.06±16.82,ranging from 19 to 81 years old.The courses of the patients were from one week to 5 years and the average course was 9.54±0.56 months.Eight patients complicated with diabetes,7 with hypertension,5 with chronic renal failure.The lesions mainly distributed symmetrically on trunk(82.35%)and lower extremities(76.47%)with sever pruritus and Koebner phenomenon.Typical lesions presented with papules in yellow bean size and yellow keratotic plugs in the center which were hard to remove.Pathological examination showed curly and broken collagen bundles eliminated vertically through a cup-shaped crater in epidermis.The treatment was mainly to control pruritus and systemic diseases.The symptoms of pruritus were improved in 8 patients,while the condition of 4 patients had no obvious change and 4 patients had new rash.One patient died from heart failure after one week of diagnosis.