Gupta A K, Siegel M T, Noble S C, Kirkby S, Rasmussen J E
Department of Dermatology, University of Michigan Medical School, Ann Arbor.
J Am Acad Dermatol. 1990 Jul;23(1):52-5. doi: 10.1016/0190-9622(90)70185-k.
Twenty-eight of 52 consecutive psoriasis inpatients admitted for therapy with the modified Goeckerman regimen had discrete, gray-white, asymptomatic, keratotic lesions approximately 4 mm in diameter at discharge from the hospital. In 18 of these 28 patients no keratoses were noted on admission. In 9 of 10 patients who had keratoses at admission, there was an increase in number at discharge. All patients with keratoses on admission had multiple, closely spaced previous admissions. No age, sex, or skin type predominance was evident in the group with keratoses compared with the remainder of the group (24 patients) who did not have keratoses. The development of keratoses was not related to the type or duration of psoriasis. Statistically significant predisposing factors were the number of UVB and PUVA treatments and the number of inpatient admissions. Fifty-two percent were located on the extremities, 33% on the trunk, and 15% on the face, head, and neck. Histologic examination of these lesions suggested that they may be a variant of seborrheic keratoses. We have not seen these lesions on patients receiving UVB, PUVA, or tar therapy for other diseases. This raises the possibility that these lesions may be unique to psoriasis and most likely are related to long-term therapy.
采用改良的格克曼疗法接受治疗的52例连续性银屑病住院患者中，有28例在出院时出现直径约4毫米、离散的灰白色、无症状角化性损害。在这28例患者中，有18例入院时未发现角化病。入院时有角化病的10例患者中，有9例出院时数量增多。所有入院时有角化病的患者之前都有多次、间隔紧密的住院史。与其余没有角化病的24例患者相比，有角化病的患者组中未发现年龄、性别或皮肤类型占优势。角化病的发生与银屑病的类型或病程无关。具有统计学意义的诱发因素是UVB和PUVA治疗的次数以及住院次数。52%位于四肢，33%位于躯干，15%位于面部、头部和颈部。对这些损害的组织学检查表明，它们可能是脂溢性角化病的一种变体。我们在接受UVB、PUVA或焦油疗法治疗其他疾病的患者中未见过这些损害。这增加了这些损害可能是银屑病特有的，且很可能与长期治疗有关的可能性。
