进食藜导致植物日光性皮炎11例临床分析

Clinical analysis of 11 patients with phytophotodermatitis caused by ingesting Chenopodium album

目的探讨进食藜导致的植物日光性皮炎的临床特点和治疗。方法对2013—2017年在济宁医学院附属医院皮肤科诊治的11例进食藜引起的植物日光性皮炎患者的一般资料、临床表现、实验室检查、治疗及预后进行回顾性分析。结果11例均为女性,年龄45~62岁,起病前1~2 d内均有进食藜史和日光暴露史。临床均表现为颜面部、双手背、前臂暴露处对称分布的非凹陷性肿胀性红斑,表面紧张光亮,伴痛痒。6例患者血白细胞计数升高,1例嗜酸性粒细胞计数升高。均系统给予甲泼尼龙、氯雷他定等治疗,2例同时应用人免疫球蛋白,3例口服洛芬待因,并均予外用药物对症治疗。10例治疗7~10 d后好转出院,1年后随访均无色素沉着及瘢痕;1例出现双手背皮肤坏死,遗留皮肤瘢痕。结论进食藜导致的植物日光性皮炎常表现为暴露部位肿胀性红斑,及时给予抗过敏治疗可有效控制病情。

Objective To investigate clinical characteristics and treatment of phytophotodermatitis due to ingesting Chenopodium album.Methods This study included 11 patients with phytophotodermatitis caused by ingesting Chenopodium album collected from Department of Dermatology,Affiliated Hospital of Jining Medical University from 2013 to 2017.The patients′general information,clinical manifestations,laboratory test results,treatment and prognosis were retrospectively analyzed.Results All the 11 patients were female,and their age ranged from 45 to 62 years.They all had a history of ingesting Chenopodium album and exposing to sunlight within 1-2 days prior to the disease onset.Clinical manifestations included symmetrically distributed,painful and pruritic,nonpitting,swelling erythema on the face and back of both hands and at sunexposed sites of forearms,with a tense and bright surface.Increased white blood cell counts were observed in 6 patients,and increased eosinophil counts in 1.All of the 11 patients were treated with systemic methylprednisolone,loratadine,ebastine,spironolactone,furosemide and omeprazole as well as topical agents,2 also received human immunoglobulin treatment,and 3 were also treated with oral ibuprofen and codeine for painful lesions.Ten patients received obvious improvement and were discharged after 7-10 days of treatment,and no pigmentation or scars were observed after 1-year follow-up.Skin necrosis occurred on the back of both hands in 1 patient after 7-day treatment,and scars remained in the patient after follow-up of half a year.Conclusions Chenopodium album-induced phytophotodermatitis commonly manifests as swelling erythema on the exposed body sites.After confirmed diagnosis,Chenopodium album ingestation and sunlight exposure should be avoided,and timely antianaphylactic treatment should be considered to effectively control the disease.