儿童肠病性肢端皮炎临床特征:附20例报告

Clinical analysis of 20 cases of childhood acrodermatitis enteropathica

目的了解儿童肠病性肢端皮炎(AE)的临床特征。方法对苏州大学附属儿童医院皮肤科门诊确诊的20例AE患儿的临床资料进行回顾性分析,并与20例体检健康儿童(对照组)比较血清中锌、铁元素水平。结果20例患儿中,男女比例为1∶1.22,平均年龄为(10.12±7.05)个月。皮疹常表现为红斑、斑片、鳞屑、糜烂、结痂,好发于口周、腹股沟、肛周、四肢末端区域,常伴发腹泻及脱发。患儿组血清锌元素水平低于对照组[(7.39±3.51)μmol/L vs(12.40±2.57)μmol/L,t=-5.15,P<0.001],铁元素水平低于对照组[(8.09±2.44)μmol/L vs(12.31±4.45)μmol/L,t=-3.17,P<0.001],差异均有统计学意义。锌治疗对所有患儿均有效。结论临床上患儿出现腔口周围皮炎、脱发、腹泻等症状时要警惕AE,血清锌、铁元素水平降低可辅助诊断。

Objective To investigate the clinical features of acrodermatitis enteropathica(AE).Methods A retrospective analysis was conducted on the clinical data of 20 children diagnosed with acrodermatitis enteropathica in the outpatient clinic at the dermatology department of our hospital.The serum levels of zinc and iron were compared between patients with acrodermatitis enteropathica and 20 health children.Results Among the 20 cases,the male-to-female ratio was 1∶1.22,with an average age of 10.12±7.05 months.The skin rashes commonly presented as erythemas,patches,scales,erosion and crusts,predominantly affecting the perioral,inguinal,perianal and extremity regions,and often accompanied by diarrhea and hair loss.The serum zinc levels in the patient group were lower than that in the controls[(7.39±3.51)μmol/L vs(12.40±2.57)μmol/L,t=-5.15,P<0.001],and the serum iron levels were also lower in the patient group than in the controls[(8.09±2.44)μmol/L vs(12.31±4.45)μmol/L,t=-3.17,P<0.001].All patients showed good response to the treatment with zinc supplementation.Conclusions In clinic,acrodermatitis enteropathica should be suspected when pediatric patients exhibit perioral dermatitis,hair loss and diarrhea.Decreased serum zinc and iron levels can help the diagnosis.