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白塞病的皮肤和皮肤外表现与其疾病活动及预后的关系

Cutaneous and Extracutaneous Manifestations of Behçet's Disease Linked to Its Disease Activity and Prognosis.

作者信息

Limtong Preeyachat, Chanprapaph Kumutnart, Vachiramon Vasanop, Ngamjanyaporn Pintip

机构信息

Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Division of Allergy Immunology and Rheumatology, Department of Internal Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

出版信息

Clin Cosmet Investig Dermatol. 2020 Aug 25;13:639-647. doi: 10.2147/CCID.S265169. eCollection 2020.

Abstract

BACKGROUND

Behçet's disease is a potentially fatal vasculitis disorder involving vessels in both the arterial and venous systems. Cutaneous manifestation is the most common sign in Behçet's disease, but its relation to disease activity and prognosis is lacking.

OBJECTIVE

Our study aims to determine the relationship between cutaneous, extracutaneous manifestations with Behçet's disease activity, morbidity, and mortality.

MATERIALS AND METHODS

Patients diagnosed with Behçet's disease were identified by using the 1990 International Study Group for Behçet's disease criteria and/or the 2014 international criteria for Behçet's disease. Data regarding patients' clinical manifestations, laboratory results, disease activity, and prognosis were retrieved and analyzed. Disease activity was evaluated using the 2006 Behçet's disease current activity form (BDCAF).

RESULTS

Of 119 patients, the mean age at diagnosis was 35.7 ± 10.7 years and 60% were female. Median disease duration was 96 months (IQR 48-168). Minor oral ulcer at the buccal mucosa was associated with lower median BDCAF score ( = 0.003), whereas minor oral ulcer at the tonsil was related to higher BDCAF score ( = 0.024). Male gender was associated with higher cumulative dose of corticosteroids ( = 0.003) and hospitalization (OR = 2.89 (95% CI [1.10, 7.57]), = 0.031). Ocular manifestations were related to higher dose of corticosteroids ( = 0.002) and morbidity (OR = 4.39 (95% CI [1.57, 12.29]), = 0.005).

CONCLUSION

Our study suggests that different locations of minor oral ulcers help predict disease activity. Male gender and the presence of ocular manifestations resulted in less favorable outcomes for Behçet's disease.

摘要

背景

白塞病是一种潜在致命的血管炎疾病,累及动脉和静脉系统的血管。皮肤表现是白塞病最常见的体征,但其与疾病活动度和预后的关系尚不明确。

目的

本研究旨在确定皮肤及皮肤外表现与白塞病活动度、发病率和死亡率之间的关系。

材料与方法

采用1990年白塞病国际研究组标准和/或2014年白塞病国际标准,确定诊断为白塞病的患者。收集并分析患者的临床表现、实验室检查结果、疾病活动度和预后等数据。采用2006年白塞病当前活动形式(BDCAF)评估疾病活动度。

结果

119例患者中,诊断时的平均年龄为35.7±10.7岁,60%为女性。疾病中位病程为96个月(四分位间距48 - 168)。颊黏膜处的轻度口腔溃疡与较低的BDCAF中位评分相关(P = 0.003),而扁桃体处的轻度口腔溃疡与较高的BDCAF评分相关(P = 0.024)。男性与更高的糖皮质激素累积剂量相关(P = 0.003)以及住院率相关(比值比 = 2.89(95%可信区间[1.10, 7.57]),P = 0.031)。眼部表现与更高剂量的糖皮质激素相关(P = 0.002)以及发病率相关(比值比 = 4.39(95%可信区间[1.57, 12.29]),P = 0.005)。

结论

我们的研究表明,轻度口腔溃疡的不同部位有助于预测疾病活动度。男性和眼部表现的存在导致白塞病的预后较差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d90e/7457676/8cdeb3bc8a85/CCID-13-639-g0001.jpg

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