Department of Dermatology, Changi General Hospital, Singapore.
Int J Dermatol. 2013 Dec;52(12):1495-9. doi: 10.1111/j.1365-4632.2012.05608.x. Epub 2013 Mar 14.
There are few studies comparing pityriasis lichenoides (PL) in adults and children, with fewer involving Asians. We compared the clinical profile and treatment outcomes of 10 adults and five children diagnosed with PL.
We retrospectively reviewed a series of patients diagnosed with PL at our hospital from 2002 to 2008.
We identified 10 adults and five children (nine adults and four children with pityriasis lichenoides chronica; one adult and one child with pityriasis lichenoides et varioliformis acuta). Mean age of onset of disease was 42.2 years in adults and 12.2 years in children. Median duration of disease before presentation was 5.5 months in adults and 6 months in children. Trunk and limbs were the most common sites of involvement. Itch was present in the majority. Almost all patients did not respond to topical corticosteroids. A good response was seen in three adults and two children treated with oral antibiotics. Three adults and two children responded to treatment with narrow-band ultraviolet B phototherapy. The median time to resolution was 8 months in adults and 21 months in children. Postinflammatory dyspigmentation was seen in six adults and four children.
PL presents similarly in adults and children; however, it runs a longer course in children. In our series, postinflammatory hyperpigmentation was common, which may be explained by our patients' darker skin phototypes. We routinely prescribe oral antibiotics initially in patients without contraindications. Phototherapy may be useful in patients not responding to antibiotics.
成人与儿童的类扁平苔藓（PL）比较研究较少，涉及亚洲人的研究则更少。我们比较了 10 名成人和 5 名儿童 PL 患者的临床特征和治疗结局。
我们回顾性分析了 2002 年至 2008 年在我院诊断为 PL 的一系列患者。
共确定了 10 名成人和 5 名儿童（9 名成人和 4 名儿童为慢性类扁平苔藓，1 名成人和 1 名儿童为急性类扁平苔藓样糠疹样疹）。成人发病年龄的平均值为 42.2 岁，儿童为 12.2 岁。成人就诊前疾病的中位病程为 5.5 个月，儿童为 6 个月。最常见的受累部位为躯干和四肢。多数患者有瘙痒。几乎所有患者对外用皮质类固醇均无反应。3 名成人和 2 名儿童接受口服抗生素治疗后病情明显改善。3 名成人和 2 名儿童接受窄谱中波紫外线光疗后病情缓解。成人的中位缓解时间为 8 个月，儿童为 21 个月。6 名成人和 4 名儿童遗留炎症后色素沉着。
PL 在成人和儿童中的表现相似，但在儿童中病程较长。在我们的研究中，炎症后色素沉着很常见，这可能与患者的深色皮肤光型有关。我们通常在没有禁忌证的患者中初始给予口服抗生素。对于对抗生素治疗无反应的患者，光疗可能有用。
