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NEJM:扁平苔癣-病例报道

2018-08-09 xing.T MedSci原创

虽然尚未明确确定扁平苔藓的病因,但它被认为是一种自身免疫性疾病。扁平苔藓与HCV感染有关。在该患者中,已经治疗的HCV感染与后来的皮疹之间的关联尚不清楚。局部或病灶内糖皮质激素可作为主要治疗,紫外线治疗和口服免疫抑制剂用于病变更广泛的病例。

患者为一名69岁的男子,因瘙痒性皮疹2个月而到皮肤科就诊。皮疹首先出现在他的右手腕上,并在2周内扩散到他的手臂、腿部和躯干。既往有慢性丙型肝炎病毒(HCV),他在皮疹发病前3个月完成了为期12周的elbasvir和grazoprevir治疗。



体格检查时,在手臂的前表面(如图A)和手的背面(如图B)以及躯干和腿部可见许多紫色丘疹。几处病灶显示出细小的网点和细纹,称为威克姆纹。病变部位活组织检查显示角化过度,楔形的颗粒状过多,锯齿状的钉突和带状淋巴细胞炎症-这些结果证实了扁平苔藓的诊断

虽然尚未明确确定扁平苔藓的病因,但它被认为是一种自身免疫性疾病。扁平苔藓与HCV感染有关。在该患者中,已经治疗的HCV感染与后来的皮疹之间的关联尚不清楚。局部或病灶内糖皮质激素可作为主要治疗,紫外线治疗和口服免疫抑制剂用于病变更广泛的病例。

该患者接受局部氯倍他索和窄带紫外线B治疗,并在治疗开始后1个月内病变减轻。

原始出处:

Ayan Kusari,et al. Lichen Planus.N Engl J Med 2018; https://www.nejm.org/doi/full/10.1056/NEJMicm1802078

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    2018-08-16 易水河

    学习学习很好

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=338951, encodeId=44b2338951a1, content=学习学习很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Thu Aug 16 09:58:42 CST 2018, time=2018-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337534, encodeId=be1733e53418, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Thu Aug 09 12:30:04 CST 2018, time=2018-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337484, encodeId=f57e33e48443, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu Aug 09 08:31:28 CST 2018, time=2018-08-09, status=1, ipAttribution=)]
    2018-08-09 哈哈869

    学习了

    0

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    2018-08-09 龙胆草

    学习谢谢分享

    0

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