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[肺结节病的皮肤病变类型及其预后价值]

[Types of skin lesions in pulmonary sarcoidosis and their prognostic value].

作者信息

Garmash Iu Iu, Soldatskaia L V, Enikeeva E G, Agadzhanova I S, Slutskaia O M

出版信息

Probl Tuberk Bolezn Legk. 2007(10):51-7.

Abstract

When sarcoidosis is suspected, a patient should be meticulously examined for dermal changes, the favorite sites of which are the skin of the face, ears, upper and lower extremities, and trunk. Elements may vary in number from solitary to multiple. When dermal changes are suspected of sarcoidosis, a dermatologist should examine the patient and, if there are some doubts about the nature of dermal elements, biopsy and histological study should be made since the morphological verification of the diagnosis primarily requires the use of extrapulmonary sites of the process, namely superficial peripheral lymph nodes, as well as the skin. The findings suggest that skin sarcoidosis characterized by the long-term chronic or progressive course is encountered at different (X-ray) stages of sarcoidosis of respiratory organs and is of poor prognostic value. The severity of dermal manifestations is no less and, in individual cases, more significant than pulmonary symptoms. Great or ugly skin lesions require prednisolone treatment. In some cases, long-term therapy cannot yield a result. Delagil treatment of dermal manifestations remains to be effective.

摘要

当怀疑患有结节病时,应对患者进行仔细检查以查找皮肤变化,其好发部位为面部、耳部、上下肢及躯干皮肤。皮损数量可从单个到多个不等。当怀疑皮肤变化为结节病时,皮肤科医生应检查患者,若对皮损性质存在疑问,应进行活检和组织学研究,因为诊断的形态学验证主要需要利用病变的肺外部位,即浅表外周淋巴结以及皮肤。研究结果表明,以长期慢性或进行性病程为特征的皮肤结节病在呼吸器官结节病的不同(X线)阶段均可出现,且预后价值较差。皮肤表现的严重程度不亚于肺部症状,在个别情况下甚至更为显著。严重或难看的皮肤损害需要使用泼尼松龙治疗。在某些情况下,长期治疗可能无效。使用德拉吉治疗皮肤表现仍有效果。

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