综合治疗反常性痤疮

Combined therapy for acne inversa

报告综合治疗HurleyⅢ级反常性痤疮1例。患者男,20岁。因头面部、躯干及会阴部出现丘疹、脓疱、结节及囊肿2年就诊。皮肤科检查:头部、面部、胸部及背部可见散在分布的绿豆大褐色色素沉着;腰骶部、双臀部、腹股沟及右侧阴囊可见散在分布花生米大的红色结节、囊肿、脓肿及溃疡,部分融合成片,伴有窦道形成,溃疡面可见脓、血性分泌物。诊断:HurleyⅢ级反常性痤疮。患者经过长时间内科治疗及外科换药,病情控制不佳,并出现低蛋白血症及中度贫血,后经外科行皮肤和皮下坏死组织切除清创术联合局部皮瓣移植术及窦道切除术,取得较好的疗效。

A 20-year-old male presented with pimples, nodules, cyst and pustule on the head, trunk and perineum for two years. Physical examination showed that mung bean-sized brown pigmentation was scattered on the head, chest and back. Red nodules, cysts, abcesses and ulcers were scattered in the lumbosacral region, buttocks, groin and right scrotum, partly fused into a piece with sinus formation. Pus and blood secretions were on the ulcer surface. According to the clinical manifestations,the diagnosis of acne inverse, Hurley Ⅲ was made. The patient has experienced misdiagnosis, long-term internal medicine therapy, surgical operation-incision and drainage abscesses. But the disease was failed to be controlled completely, and the patient has been undergoing the suffer of hypoalbuminemia and moderate anemia. After the patient underwent surgical operation,debridement of skin and subcutaneous tissue combined with local flap transplantation and sinectomy, he was markedly improved.