青少年男性暴发性痤疮11例临床分析及文献回顾

Clinical Analysis and Literature Review of 11 Cases of Adolescent Male Acne Fulminant

目的 回顾分析暴发性痤疮(AF)患者的临床特点、实验室检查及治疗,以便更好地了解该病的临床过程和转归。方法 收集2018年11月-2021年12月武汉市第一医院皮肤科收治的暴发性痤疮患者的临床资料,总结其临床特点及病情转归。结果 报告11例暴发性痤疮患者均为男性,7例患者诱发与口服异维A酸相关,2例患者伴发热。单独使用抗生素治疗,治疗反应差,系统糖皮质激素联合小剂量异维A酸治疗,患者的反应好,但激素减量过快时,痤疮有复发加重的趋势。结论 常规剂量异维A酸可能诱发或加重暴发性痤疮,积极的糖皮质激素抗炎治疗联合小剂量异维A酸是尽快控制炎症反应并获得良好的后期疗效的决定性治疗方案,但临床上需正确鉴别暴发性痤疮并警惕异维A酸开始治疗的时机及初始剂量。

Objective To review and analyze the clinical characteristics, laboratory examination and treatment of patients with acne fulminant(AF) in order to better understand the clinical process and outcome of the disease.Methods The clinical data of AF patients treated in the Department of Dermatology, Wuhan First Hospital from November 2018 to December 2021 were collected, and the clinical features and prognosis were summarized.Results Eleven patients with AF were all male.Seven patients were induced by oral isotretinoin and 2 patients had fever.The response of patients treated with antibiotics alone was poor, and the response of patients treated with systemic corticosteroids combined with low-dose isotretinoin was good. When the reduction of glucocorticoids was too fast, acne had a tendency to relapse.Conclusion Conventional dose of isotretinoin may induce or aggravate AF.Oral corticosteroids combined with low-dose isotretinoin is a decisive treatment scheme to control inflammatory reaction and obtain good late curative effect, but it is necessary to correctly identify AF and pay attention to the timing and initial dose of isotretinoin.