接触苯扎氯铵后发生颗粒状角化不全7例临床特征分析

nalysis of clinical features of seven patients with granular parakeratosis after benzalkonium chloride exposure

目的总结接触苯扎氯铵后发生的颗粒状角化不全(GP)的临床表现和组织病理学特征。方法回顾性分析2022年4-8月在武汉市第一医院皮肤科就诊的7例有苯扎氯铵接触史的GP病例,收集患者一般情况、皮损表现、病理检查、治疗和随访信息。结果7例GP均为成年患者,典型表现为发生在间擦部位的红斑和棕色鳞屑,呈环状分布。7例患者均报告近期接触过含有苯扎氯铵的消毒液。7例患者共收集10份皮损标本,组织病理检查均显示特征性角化过度和角质层内蓝灰色细颗粒状角化不全。停止暴露于苯扎氯铵1个月后皮损均好转。结论GP具有独特的临床表现和组织病理学表现,苯扎氯铵暴露史有助于诊断GP。

Objective To summarize clinical manifestations and histopathological features of granular parakeratosis(GP)after exposure to benzalkonium chloride.Methods A retrospective analysis was performed on 7 GP cases with a history of benzalkonium chloride exposure in the Department of Dermatology at Wuhan No.1 Hospital from April to August 2022.Data were collected on the general condition,skin lesion manifestations,pathological examination,treatment,and follow-up of the patients,and retrospectively analyzed.Results The 7 adult patients with GP typically presented with erythema and brown scales in the intertriginous area,exhibiting an annular distribution pattern.All the 7 patients reported recent exposure to disinfectants containing benzalkonium chloride.A total of 10 skin biopsies were taken from the 7 patients.Histopathological examination showed characteristic hyperkeratosis and fine blue-gray parakeratotic granules in the stratum corneum.All skin lesions improved 1 month after cessation of exposure to benzalkonium chloride.Conclusion GP has a distinct clinical pattern and histopathological manifestations,and a history of exposure to benzalkonium chloride can be helpful for the diagnosis of GP.