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[口周皮炎患者的统计研究及治疗结果]

[Statistical studies and results of treatment of patients with perioral dermatitis].

作者信息

Wilsch L, Hornstein O P

出版信息

Z Psychosom Med Psychoanal. 1976 Jan-Mar;22(1):115-25.

PMID:941528
Abstract

279 patients suffering from perioral rosaceiform dermatitis have been treated during the past 5 years. With the exception of two men and one five-year-old girl, all patients were female adults, mostly in their thirties. Skin eruptions had been present for 1--2 years in 73% of the cases. Two third of the patients had been treated locally with corticosteroids and one tenth of this group had previously undergone systemic therapy. In 22,2% of the patients, typical signs of local corticosteroid overtreatment were seen. There was a great number of patients holding rather high-ranking jobs and showing remarkable zeal to advance either in their habitual professional field or in a new career. 90% of the perioral dermatitis patients suffered from concomitant vegetative disturbances, especially nervousness, insomnia, headaches and fatigue. In 40% of the cases, symptoms of general neurovascular lability were stated and 60% complained of digestive troubles, particularly obstipation. Out of 220 patients, 206 (=93%) supervised since the end of our treatment showed no relapse of their dermatosis. Our therapeutic program since 1970 consists of mild, corti-costeroid-free local treatment and psychotherapy (see A. Thurn). In the majority of cases, the skin lesions disappeared during the first 3 months and in 90% after 6 months. In 33 cases, under conditions of stress and conflict, one or several relapses occured before final recovery was attained. The evaluation of therapy results showed a progredient reduction of recovery time corresponding to the increasing psychoanalytical experience of our interdisciplinary team. However, in perioral dermatitis patients showing no concomitant vegetative symptoms (10%), a conspiciously longer recovery time was noted, when compared with the remainder of our cases. Patients suffering from several concomitant vegetative symptoms may possibly stop, taking out' psychic problems on their skin when partially resolved by short-term therapy, tending instead to ,somatize' their conflicts in other susceptible organs.

摘要

在过去5年里,我们对279例口周酒渣鼻样皮炎患者进行了治疗。除了2名男性和1名5岁女孩外,所有患者均为成年女性,大多为30多岁。73%的病例中,皮肤疹已出现1至2年。三分之二的患者曾局部使用过皮质类固醇,其中十分之一的患者此前接受过全身治疗。22.2%的患者出现了局部皮质类固醇过度治疗的典型症状。有大量患者担任相当高级别的工作,并表现出极大的热情,希望在其惯常的专业领域或新的职业中取得进步。90%的口周皮炎患者伴有植物神经功能紊乱,尤其是紧张、失眠、头痛和疲劳。40%的病例有一般神经血管不稳定的症状,60%的患者抱怨有消化系统问题,尤其是便秘。在220例患者中,自我们治疗结束后接受观察的206例(93%)患者的皮肤病没有复发。自1970年以来,我们的治疗方案包括温和的、不含皮质类固醇的局部治疗和心理治疗(见A. 图恩)。在大多数情况下,皮肤病变在最初3个月内消失,90%在6个月后消失。在33例患者中,在压力和冲突的情况下,在最终康复之前出现了一次或几次复发。对治疗结果的评估表明,随着我们跨学科团队精神分析经验的增加,恢复时间逐渐缩短。然而,与我们其余的病例相比,在没有伴随植物神经症状的口周皮炎患者(10%)中,恢复时间明显更长。患有多种伴随植物神经症状的患者,当通过短期治疗部分解决时,可能会停止在皮肤上“发泄”心理问题,而是倾向于在其他易受影响的器官中“躯体化”他们的冲突。

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