CAJ | 학술논문

目的探讨反常性痤疮的临床特点及治疗经验.方法回顾性分析于我院住院治疗的8例反常性痤疮患者的临床资料.结果 8例患者入院时皮损均有瘢痕、脓性分泌物和不同程度的疼痛,6例出现高热.男7例,女1例,发病年龄6 ～ 30岁,平均17岁.7例患者无家族史.由于该病多病灶的特点,选择局部或系统药物治疗,常用药物包括抗生素、异维A酸和糖皮质激素,也可选择使用抗雄激素类药物、免疫抑制剂以及肿瘤坏死因子α抑制剂.手术扩大切除用于治疗严重的HurleyⅢ级.4例行手术治疗的患者住院时间为8～47d,平均27.75 d.4例未行手术治疗的患者住院时间为13 ～ 123 d,平均46.5 d.4例患者出院后病情反复;1例经手术治疗痊愈,出院5年后于肛周新发脓肿、结节;3例失访.结论反常性痤疮的发病可以有家族性也可散发.以抗生素、异维A酸和糖皮质激素类药物最为常用.外科手术的目的是切除瘢痕束和引流脓肿.
목적 탐토반상성좌창적림상특점급치료경험.방법 회고성분석우아원주원치료적8례반상성좌창환자적림상자료.결과 8례환자입원시피손균유반흔、농성분비물화불동정도적동통,6례출현고열.남7례,녀1례,발병년령6 ～ 30세,평균17세.7례환자무가족사.유우해병다병조적특점,선택국부혹계통약물치료,상용약물포괄항생소、이유A산화당피질격소,야가선택사용항웅격소류약물、면역억제제이급종류배사인자α억제제.수술확대절제용우치료엄중적HurleyⅢ급.4례행수술치료적환자주원시간위8～47d,평균27.75 d.4례미행수술치료적환자주원시간위13 ～ 123 d,평균46.5 d.4례환자출원후병정반복;1례경수술치료전유,출원5년후우항주신발농종、결절;3례실방.결론 반상성좌창적발병가이유가족성야가산발.이항생소、이유A산화당피질격소류약물최위상용.외과수술적목적시절제반흔속화인류농종.
Objective To investigate the clinical feature and treatment of acne inversa.Methods This study included eight patients (7 males and 1 female) hospitalized for acne inversa in the Institute of Dermatology,Chinese Academy of Medical Sciences and Peking Union Medical College.Clinical data were retrospectively collected and analyzed.Results All the patients presented with characteristic clinical manifestations on admission,including disfiguring scars and purulent secretions with different levels of pain.Six patients had hyperpyrexia during hospitalization.The average age at onset was 17 years (range,6-30 years).Seven patients had no family history.Topical or systemic therapy may be tried because of the multifocal nature of the disease.It was often treated by antibiotics,isotretinoin and glucocorticoids,and sometimes by tumor necrosis factor α-inhibitors,anti-androgens and immunosuppressive agents.Wide surgical excision was frequently used for the control of severe conditions,e.g.,acne inversa of Hurley grade Ⅲ.The hospital stay varied from 8 to 47 days (average,27.75 days) for four patients undergoing surgical treatment,from 13 to 123 days (average,46.5 days) for four patients receiving no surgical treatment.Four patients experienced recurrence after hospital discharge,one patient was cured after surgical treatment but developed novel abscesses and nodules in perianal region five years later,three patients were lost to follow-up.Conlusions Acne inversa,which can be either familial or sporadic,is commonly treated by antibiotics,isotretinoin and glucocorticoids.Surgical operation can be used to remove cicatricial bands and drained abscesses in patients with acne inversa.