Seki K, Amano T, Nakayama Y
Department of Orthopaedics, Himeji National Hospital.
Ryumachi. 1997 Aug;37(4):568-73.
Pustular psoriasis is a rare skin disease that is observed in about 1% of all patients with psoriasis. We encounted a patient with psoriatic arthritis (PsA) due to pustular psoriasis. The patient was a 31-year old male. He visited our hospital due to generalized eruption and pain in multiple joints. Treatment was initiated under a diagnosis of psoriasis vulgaris and associated PsA. However, eruption extended to the entire body and became pustular, and fever developed. Since PsA symptoms were simultaneously aggravated, and body movements become difficult, he was admitted. A diagnosis of generalized pustular psoriasis (von Zumbusch) and associated symmetrical polyarthritis was made. Local therapy was performed. As systemic treatment, oral administration of an corticosteroid and weekly low-dose pulse methotrexate therapy were performed. The skin symptoms and PsA symptoms rapidly improved. At present, about one year after the initiation of treatment, the eruption almost completely disappeared, and joint pain does not present any problem in daily life.
脓疱型银屑病是一种罕见的皮肤病，约占所有银屑病患者的1%。我们遇到了一名因脓疱型银屑病而患有银屑病关节炎（PsA）的患者。该患者为31岁男性。他因全身皮疹和多关节疼痛前来我院就诊。在诊断为寻常型银屑病及相关PsA后开始治疗。然而，皮疹蔓延至全身并发展为脓疱，同时出现发热。由于PsA症状同时加重，身体活动变得困难，遂入院治疗。诊断为泛发性脓疱型银屑病（von Zumbusch型）及相关对称性多关节炎。进行了局部治疗。作为全身治疗，口服皮质类固醇并每周进行低剂量脉冲甲氨蝶呤治疗。皮肤症状和PsA症状迅速改善。目前，治疗开始约一年后，皮疹几乎完全消失，关节疼痛在日常生活中也未造成任何问题。
