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先天性糜烂性水疱性皮肤病伴网状柔软性瘢痕:统一的临床特征。

Congenital erosive and vesicular dermatosis with reticulated supple scarring: unifying clinical features.

机构信息

Department of Dermatology, Columbia University College of Physicians and Surgeons, New York, New York.

出版信息

J Am Acad Dermatol. 2013 Dec;69(6):909-15. doi: 10.1016/j.jaad.2013.08.015. Epub 2013 Oct 5.

DOI:10.1016/j.jaad.2013.08.015
PMID:24099729
Abstract

BACKGROUND

Congenital erosive and vesicular dermatosis (CEVD) healing with reticulated supple scarring, a condition usually observed in premature neonates, presents at birth with vesicles and erosions. Lesions typically heal within a few months, leaving behind scarring with a distinctive supple and reticulated texture.

OBJECTIVES

We sought to merge existing literature with new cases to further define CEVD.

METHODS

We analyzed 19 previous reports of CEVD and added 9 additional patients; we identified unifying characteristics of this cohort.

RESULTS

In 28 total cases, notable features included: preterm birth (79%), nail abnormalities (46%), hyperthermia/hypohidrosis (46%), a history of maternal chorioamnionitis (43%), alopecia (43%), neurodevelopmental and ophthalmologic abnormalities (36% each), tongue atrophy (29%), or a combination of these. Patients with CEVD may be prone to postnatal herpetic superinfections. Previously unreported findings included: erosive lichen planus, digital tip gangrene, and hydronephrosis.

LIMITATIONS

The small patient sampling makes it difficult to define diagnostic criteria. As certain findings are associated with prematurity, it is unclear to what extent these features result from CEVD, premature birth, or another intrauterine pathology.

CONCLUSIONS

Although rare, CEVD should be considered in the differential diagnosis of neonatal vesicles/erosions in the context of a negative infectious workup. This review strengthens the spectrum of CEVD features, thus facilitating its recognition by clinicians.

摘要

背景

先天性糜烂性水疱状皮肤病(CEVD)以网状柔软瘢痕愈合为特征,这种情况通常发生在早产儿中,患儿出生时即出现水疱和糜烂。皮损通常在数月内愈合,留下具有独特柔软和网状纹理的瘢痕。

目的

我们旨在将现有文献与新病例相结合,以进一步定义 CEVD。

方法

我们分析了 19 份先前关于 CEVD 的报告,并加入了 9 例新病例;我们确定了该队列的统一特征。

结果

在 28 例总病例中,显著特征包括:早产(79%)、指甲异常(46%)、体温过高/少汗(46%)、母亲绒毛膜羊膜炎史(43%)、脱发(43%)、神经发育和眼科异常(各 36%)、舌萎缩(29%)或这些特征的组合。CEVD 患者可能容易发生产后疱疹性感染。以前未报道的发现包括:糜烂性扁平苔藓、指尖坏疽和肾积水。

局限性

小样本患者使得难以定义诊断标准。由于某些发现与早产有关,因此尚不清楚这些特征在多大程度上是由 CEVD、早产还是其他宫内病理引起的。

结论

尽管罕见,但在进行阴性感染性检查时,应将 CEVD 纳入新生儿水疱/糜烂的鉴别诊断中。本综述加强了 CEVD 特征的范围,从而有助于临床医生识别它。

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