[与胰岛素依赖型糖尿病相关的溃疡性类脂质渐进性坏死。口服皮质类固醇治疗的有益效果]
[Ulcerated necrobiosis lipoidica associated with insulin-dependent diabetes mellitus. Beneficial effect of corticosteroid therapy by oral administration].
作者信息
Hocqueloux L, Gautier J F, Lebbe C, Jellal M, Vexiau P, Morel P, Cathelineau G
机构信息
Service d'Endocrinologie, Hôpital Saint-Louis, Paris.
出版信息
Presse Med. 1996;25(1):25-7.
OBJECTIVES
Necrobiosis lipoidica is a rare degenerative disease of dermal connective tissue usually observed in young diabetic patients. Several drugs have been suggested to be useful, but none have been shown to be effective in all cases.
CASE REPORT
A young patient with insulin-dependent diabetes had a severe invalidating ulcerated necrobiosis lipoidica. Oral corticosteroids led to a satisfactory regression then stabilization with 6 mg/d prednisone.
DISCUSSION
Oral corticosteroids would appear to be effective treatment and should be validated by controlled studies. Corticosteroids should only be used in exceptionally severe forms of ulcerated necrobiosis lipoidica after failure of conventional treatments. Diabetes would be an indication under strict metabolic control.
目的
类脂质渐进性坏死是一种罕见的皮肤结缔组织退行性疾病，通常见于年轻糖尿病患者。已有多种药物被认为可能有效，但尚无一种药物在所有病例中均显示有效。
病例报告
一名年轻的胰岛素依赖型糖尿病患者患有严重致残性溃疡性类脂质渐进性坏死。口服皮质类固醇使病情得到满意缓解，随后以6毫克/天的泼尼松维持病情稳定。
讨论
口服皮质类固醇似乎是有效的治疗方法，应通过对照研究加以验证。皮质类固醇仅应用于常规治疗失败后极为严重的溃疡性类脂质渐进性坏死病例。糖尿病患者在严格的代谢控制下可作为使用指征。
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