Zhang Ping, Chen Hong-Xiang, Xing Jian-Jun, Jin Zhao, Hu Feng, Li Teng-Long, Zhou Xiao-Yong
Department of Dermatology, Wuhan First Hospital, Wuhan, 430022, China.
Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
J Huazhong Univ Sci Technolog Med Sci. 2017 Aug;37(4):563-567. doi: 10.1007/s11596-017-1773-1. Epub 2017 Aug 8.
Erythroderma with complicated etiology is one of the severe skin diseases and has high mortality, of which the incidence was 0.5‰-1.5‰ in skin diseases. Erythrodermic psoriasis (EP) is the commonest type of erythroderma. In addition, there are drug-induced erythroderma, erythroderma secondary to preexisting dermatoses, malignancy-related erythroderma, and idiopathic erythroderma of unknown etiology. Erythroderma of different etiologies has various clinical manifestations, resulting in relevant curative effects and outcomes. In this article, we retrospectively investigated 205 erythroderma patients about clinical symptoms, auxiliary examination and treatments, and evaluated the efficacy and prognosis. There were 84 cases of EP among 205 patients, 10 cases of erythroderma caused by specific drugs, 77 cases of erythroderma secondary to preexisting dermatoses (excluding psoriasis), 7 cases of erythroderma patients suffering from malignancy and 27 cases with unknown causes. We concluded that the etiology of male patients in different age groups had significant difference. The incidence of EP was the highest among all types. The EP was commonly accompanied with hypoproteinemia, and changed into psoriasis vulgaris after treatment. Drug-induced erythroderma was commonly accompanied with fever, and mostly cured by systematic steroid therapy. For erythroderma secondary to preexisting dermatoses, the original dermatoses must be actively treated to achieve a satisfying prognosis. Erythroderma with malignancy or unknown causes had long-term duration, poor response to the treatment, and high potential to relapse. Therefore, clarifying the etiology, providing an appropiate and individual regimen, and regular follow-up are crucial for the successful treatment of erythroderma with unknown causes.
病因复杂的红皮病是严重的皮肤病之一,死亡率高,在皮肤病中发病率为0.5‰ - 1.5‰。红皮病型银屑病(EP)是红皮病最常见的类型。此外,还有药物性红皮病、继发于原有皮肤病的红皮病、恶性肿瘤相关红皮病以及病因不明的特发性红皮病。不同病因的红皮病有各种临床表现,导致相应的疗效和结局。本文回顾性调查了205例红皮病患者的临床症状、辅助检查及治疗情况,并评估了疗效和预后。205例患者中,EP有84例,特定药物引起的红皮病10例,继发于原有皮肤病(不包括银屑病)的红皮病77例,患有恶性肿瘤的红皮病患者7例,病因不明者27例。我们得出结论,不同年龄组男性患者的病因有显著差异。EP在所有类型中发病率最高。EP常伴有低蛋白血症,治疗后转变为寻常型银屑病。药物性红皮病常伴有发热,大多通过系统性类固醇治疗治愈。对于继发于原有皮肤病的红皮病,必须积极治疗原有的皮肤病以获得满意的预后。伴有恶性肿瘤或病因不明的红皮病病程长,治疗反应差,复发可能性高。因此,明确病因、提供合适的个体化治疗方案并定期随访对于成功治疗病因不明的红皮病至关重要。