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强力霉素联合窄谱中波紫外线光疗治疗获得性反应性穿通性胶原病

Doxycycline Combined with NB-UVB Phototherapy for Acquired Reactive Perforating Collagenosis.

作者信息

Gao Limu, Gu Lixiong, Chen Zhen, Cao Shuanglin

机构信息

Department of Dermatology, Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, People's Republic of China.

出版信息

Ther Clin Risk Manag. 2020 Sep 24;16:917-921. doi: 10.2147/TCRM.S271058. eCollection 2020.

Abstract

BACKGROUND

Acquired reactive perforating collagenosis is a rare skin disease characterized by the discharge of collagen fibers through the epidermis. There is no standard treatment for this disease currently. Here, we report a case of ARPC that has been successfully treated and cured.

CASE DESCRIPTION

A 32-year-old man developed severe itching papules on his torso and limbs for 3 months. Skin lesions were keratotic papules scattered on the limbs and trunk, with a diameter of 3 to 12 mm. Some lesions had umbilical recesses and the shape of a crater with positive isomorphic reactions. The patient scratched his severe itching lesions which merged into large ones. This patient had histories of hypertension and dilated cardiomyopathy with mild congestive heart failure. The clinical presentation and histopathology of skin lesions met Faver's diagnostic criteria for ARPC.

TREATMENT

Oral Doxycycline 100mg/d, NB-UVB phototherapy 3 times a week with initial dose 400mJ/cm, gradually increased to 1200mJ/cm(total cumulative dose 16700J/cm).

OUTCOMES

After a week of treatment, the patient's itching symptoms were significantly reduced and stopped presenting any new skin lesions. Most of the lesions healed in 6 weeks of treatment.

LESSONS

Doxycycline combined with NB-UVB may be an effective treatment for ARPC.

摘要

背景

获得性反应性穿通性胶原病是一种罕见的皮肤病,其特征是胶原纤维通过表皮排出。目前该病尚无标准治疗方法。在此,我们报告一例已成功治疗并治愈的获得性反应性穿通性胶原病病例。

病例描述

一名32岁男性躯干和四肢出现严重瘙痒性丘疹3个月。皮肤损害为散在于四肢和躯干的角化性丘疹,直径3至12毫米。部分损害有脐凹及火山口样外观,同形反应阳性。患者搔抓其严重瘙痒的皮损,皮损融合成大片。该患者有高血压病史及扩张型心肌病伴轻度充血性心力衰竭。皮肤损害的临床表现和组织病理学符合法弗尔关于获得性反应性穿通性胶原病的诊断标准。

治疗

口服多西环素100毫克/天,窄谱中波紫外线(NB-UVB)光疗每周3次,初始剂量400毫焦/平方厘米,逐渐增至1200毫焦/平方厘米(总累积剂量16700焦/平方厘米)。

结果

治疗一周后,患者瘙痒症状明显减轻,未再出现任何新的皮肤损害。大多数损害在治疗6周后愈合。

经验教训

多西环素联合NB-UVB可能是治疗获得性反应性穿通性胶原病的有效方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f89a/7522401/35cf07bd4aac/TCRM-16-917-g0001.jpg

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