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水源性角化病患儿的临床及进化特征:12例患者的回顾性研究

[Clinical and evolutionary characteristics of a child with aquagenic keratoderma: A retrospective study of 12 patients].

作者信息

Denos C, Dreyfus I, Chiaverini C, Labreze C, Abasq C, Phan A, Mallet S, Monteil L, Mazereeuw-Hautier J

机构信息

Centre de référence des maladies rares de la peau, CHU Toulouse-Larrey, 24, chemin de pouvourville, 31400 Toulouse, France.

Centre de référence des maladies rares de la peau, CHU Toulouse-Larrey, 24, chemin de pouvourville, 31400 Toulouse, France.

出版信息

Ann Dermatol Venereol. 2018 Apr;145(4):250-256. doi: 10.1016/j.annder.2018.01.042. Epub 2018 Feb 24.

Abstract

INTRODUCTION

Aquagenic keratoderma (AK) is a rare condition characterized by wrinkled and edematous appearance of the skin of the hands occurring within minutes of immersion in water. Other than in a setting of cystic fibrosis, AK has rarely been reported in children, with only 13 clinical cases on record. Many clinicians are unfamiliar with AK and have fears relating to the association with cystic fibrosis The aim of this study is to describe the characteristics and to discuss management of the disease.

METHODS

Retrospective, multicentre study, including children aged under 16 years presenting AK.

RESULTS

12 children were included. KA started at a mean age of 9.25 years (range: 20 months to 15 years). Clinical appearance and mode of onset were classical, with the palms being more severely affected than the soles. Pruritus or pain were reported in six cases. The median impact on daily life was 1.5/10. Some of the children underwent investigations: two had a negative sweat test, three had molecular analysis of the gene CFTR: one was negative and two had a heterozygote mutation. The course of the disease was variable: eight stabilizations, two exacerbations, one cure and one improvement.

DISCUSSION

This is the first series on childhood KA. Clinical characteristics were similar to those seen in adults. Impact was moderate and the disease course was variable. Systematic medical check-up for cystic fibrosis does not appear warranted in children since to date, cystic fibrosis has not been diagnosed in any patients presenting AK alone.

CONCLUSION

AK is rare in children and should not cause erroneous concern, and improvement can occur.

摘要

引言

水源性角化病(AK)是一种罕见病症,其特征为手部皮肤在浸入水中几分钟内出现起皱和水肿外观。除了在囊性纤维化的背景下,儿童期AK鲜有报道,仅有13例临床病例记录在案。许多临床医生不熟悉AK,且担心其与囊性纤维化的关联。本研究的目的是描述该疾病的特征并讨论其治疗方法。

方法

一项回顾性多中心研究,纳入16岁以下患有AK的儿童。

结果

共纳入12名儿童。AK发病的平均年龄为9.25岁(范围:20个月至15岁)。临床表现和发病方式典型,手掌比脚底受影响更严重。6例报告有瘙痒或疼痛。对日常生活的影响中位数为1.5/10。部分儿童接受了检查:2例汗液试验阴性,3例进行了CFTR基因分子分析,1例阴性,2例为杂合子突变。疾病病程各异:8例病情稳定,2例加重,1例治愈,1例改善。

讨论

这是关于儿童期AK的首个系列研究。临床特征与成人所见相似。影响程度中等,疾病病程各异。由于迄今为止,仅患AK的患者中尚未诊断出囊性纤维化,因此对儿童进行系统性囊性纤维化医学检查似乎并无必要。

结论

AK在儿童中罕见,不应引起不必要的担忧,且病情可能改善。

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