以皮肤白斑为首发症状的Vogt-小柳-原田综合征1例

Vogt-Koyanagi-Harada Syndrome with Skin Leukoplakia as the First Symptom:A Case Report

患者男,48岁,左大腿内侧、颈部白斑3年,泛发全身伴白发1年半,2年半前曾双眼视朦、耳鸣,于1年半前就诊。眼底血管荧光素造影(FFA)可见视盘旁及后极部多点荧光素渗漏。皮肤科情况:头顶、面部、躯干、四肢散在大量白色斑片,边界清楚,形状不规则,部分边缘有色素沉着,头皮白斑处可见白发。诊断:Vogt-小柳-原田综合征,予口服小剂量激素、配合补益肝肾中药汤剂和外用白芷、补骨脂中药酊剂,面部、躯干、下肢白斑大部分复色,但头皮、手背白斑、白发改善不明显。

A 48-year-old male was admitted to our department because of leukoplakia on the left inner thigh and neck for 3 years,generalized white hair throughout the body for 1.5 years,and binocular blindness and tinnitus 2.5 years ago.Fundus fluorescein angiography(FFA)showed multiple fluorescein leakage around the optic disc and the posterior pole.Dermatologyic examination showed a large number of white patches scattered on the top of the head,face,trunk and limbs,with clear boundaries and irregular shapes,and some edges with pigmentation.White hair could be seen in the white spots of the scalp.The patient was diagnosed with Vogt-Koyanagi-Harada syndrome.After oral administration of low-dose steroids,herbal decoction for liver and kidney tonification,and topical application of Bai Zhi and Bu Gu Zhi tincture,most of the white spots on the face,trunk and lower limbs recovered color,but the white spots and white hair on the scalp and back of hands did not improve obviously.