氯丁酸甲酯致职业性接触性皮炎5例临床分析

Occupational contact dermatitis caused by methyl chlorobutyrate:a clinical analysis of 5 cases

回顾性分析2021年9—10月济宁医学院附属医院皮肤科及济宁市金乡县马庙镇医院内科诊治的5例氯丁酸甲酯致职业性接触性皮炎患者的临床资料。5例患者年龄33~47岁,均为男性,起病前1~4 d内均有氯丁酸甲酯接触史。3例患者住院治疗,2例患者门诊治疗。临床均表现为程度不等的躯干或四肢红斑基础上散在分布大小不等的水疱、大疱,疱壁薄,疱液清,局部破溃、渗出;口腔、外阴未见糜烂、破溃。5例患者血白细胞计数均升高,2例肝功能异常。住院患者系统给予甲泼尼龙、氯雷他定等治疗,1例同时应用人免疫球蛋白及盐酸莫西沙星注射液,2例给予保肝药物治疗,门诊患者给予醋酸泼尼松及氯雷他定等治疗,5例患者均予外用药物对症治疗。住院患者治疗14~30 d后均好转出院,门诊患者治疗14 d后皮疹消退,1个月后随访均无复发。提示,氯丁酸甲酯导致的职业性接触性皮炎为原发刺激性接触性皮炎,常表现为躯干或四肢部位红斑及水疱,及时给予抗过敏治疗可有效控制病情。

The clinical data of 5 patients with occupational contact dermatitis caused by methyl chlorobutyrate treated in the Affiliated Hospital of Jining Medical College and Mamiao Township Hospital of Jinxiang County from September to October 2021 were retrospectively analyzed.Patients were all males aged 33-47 years with a history of exposure to methyl chlorobutyrate 1 to 4 d before the onset of symptoms.Three patients were hospitalized and 2 patients were treated in outpatient clinic.The clinical manifestations were erythema on the trunk or extremities of varying degrees,scattered with blisters and bullae of different sizes,with thin and clear blisters,local ulceration and exudation;no erosion or ulceration was found in the oral cavity and vulva.All 5 patients had elevated white blood cell counts,and 2 patients had abnormal liver function.All patients received symptomatic treatment with topical drugs.Three hospitalized patients were given methylprednisolone and loratadine;in addition,1 case also received human immunoglobulin and moxifloxacin hydrochloride injection and 2 cases received hepatoprotective drugs.Two outpatients were given prednisone acetate and loratadine for treatment.Three hospitalized patients were all improved and discharged after 14-30 d of treatment.The rash of 2 outpatients subsided after 14 d of treatment,and there was no recurrence after 1-month follow-up.The occupational contact dermatitis caused by methyl chlorobutyrate is primary irritant contact dermatitis,often manifested as erythema and blisters on the trunk or limbs,and timely anti-allergic treatment can effectively control the disease.