Przybilla B, Ring J, Enders F, Winkelmann H
Dermatology Clinic and Policlinic, Ludwig-Maximilians-University, Munich, Federal Republic of Germany.
Acta Derm Venereol. 1991;71(5):407-10.
In the diagnosis of atopic eczema, minor physical markers (stigmata) frequently provide valuable clues. The prevalence of nine stigmata (dry skin, hyperlinearity of the palms or soles, infraorbital fold, white dermographism, facial pallor, orbital darkening, Hertoghe's sign, low hairline) was evaluated in 34 atopic eczema patients without atopic respiratory disease, in 16 patients with allergic rhinitis and/or asthma without atopic eczema, and in 23 controls without atopic respiratory or eczematous disease, and with negative results at prick testing with three common aeroallergens. Compared with controls, all features except Hertoghe's sign were significantly (p less than 0.01) more frequent in atopic eczema, and, except for Hertoghe's sign, dry skin and white dermographism, they were significantly (low hairline, p less than 0.05; others, p less than 0.01) more frequent also in respiratory disease. The prevalence of most stigmata did not differ significantly (p greater than 0.05) in cutaneous vs. respiratory atopic disease, only dry skin being more frequent in atopic eczema (p less than 0.05). Although not specific, most stigmata are characteristic markers not only of atopic eczema, but of atopy as such.
在特应性皮炎的诊断中，一些轻微的体征常常能提供有价值的线索。对34例无特应性呼吸道疾病的特应性皮炎患者、16例有过敏性鼻炎和/或哮喘但无特应性皮炎的患者以及23例无特应性呼吸道或湿疹性疾病且对三种常见气传变应原点刺试验结果为阴性的对照者，评估了九种体征（皮肤干燥、手掌或足底皮肤纹理增粗、眶下皱襞、白色皮肤划痕症、面色苍白、眶周色素沉着、赫托格征、发际线低）的发生率。与对照组相比，除赫托格征外，所有体征在特应性皮炎患者中出现的频率均显著更高（p<0.01），并且除赫托格征、皮肤干燥和白色皮肤划痕症外，这些体征在呼吸道疾病患者中出现的频率也显著更高（发际线低，p<0.05；其他，p<0.01）。大多数体征在皮肤型与呼吸道型特应性疾病中的发生率无显著差异（p>0.05），仅皮肤干燥在特应性皮炎中更为常见（p<0.05）。虽然这些体征并非特异性的，但大多数不仅是特应性皮炎的特征性标志，也是特应性本身的特征性标志。
