泛发性脓疱型银屑病合并亚急性皮肤型红斑狼疮一例

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A Case of Generalized Pustular Psoriasis Complicated with Subacute Cutaneous Lupus Erythematosus

Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

摘要:
泛发性脓疱型银屑病(generalized pustular psoriasis, GPP)是一种以皮肤大面积红斑、脓疱、发热、白细胞增多为主要表现且反复发作的系统性炎症性疾病。亚急性皮肤型红斑狼疮(subacute cutaneous lupus erythematosus, SCLE)是介于盘状红斑狼疮和系统性红斑狼疮之间的自身免疫性疾病, 两者并发少见。本文报道一例GPP合并SCLE病例, 分析其临床表现、实验室检查结果及两种疾病并发的原因。
- 泛发性脓疱型银屑病 /
- 亚急性皮肤型红斑狼疮
Abstract:
Generalized pustular psoriasis (GPP) is a systemic inflammatory disease with recurrent episodes of erythema, pustules, fever and leukocytosis. Subacute cutaneous lupus erythematosus (SCLE) is an autoimmune disease between discoid lupus erythematosus and systemic lupus erythematosus.Coexistence of the two diseases is uncommon. Here we report a case of generalized pustular psoriasis combined with subacute skin lupus erythematosus. The clinical manifestations and laboratory results are presented and the possible reasons for coexistence are discussed.
- generalized pustular psoriasis /
- subacute cutaneous lupus erythematotus

图 1 患者治疗前后皮疹表现

A.躯干、四肢水肿性红斑，红斑上脓疱，脱屑；B.红斑上见粟粒大小脓疱；C.治疗3周后躯干红斑、脓疱完全消退

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图 2 组织病理检查示表皮角化过度伴角化不全，棘层增厚。真皮乳头血管扩张，周围淋巴细胞、组织细胞，少量中性粒细胞浸润(HE，×100)

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[1]	Unal I, Ceylan C, Ozdemir F, et al. ITP as an initial manifestation of subacute cutaneous lupus erythematosus[J]. J Dermatol, 2005, 32:727-730. doi: 10.1111/j.1346-8138.2005.tb00833.x
[2]	夏济平, 毕志刚, 张美华, 等.系统性红斑狼疮并发脓疱性银屑病和乙型肝炎[J].临床皮肤科杂志, 2008:383-385. doi: 10.3969/j.issn.1000-4963.2008.06.016
[3]	Tselios K, Yap KS, Pakchotanon R, et al. Psoriasis in systemic lupus erythematosus:a single-center experience[J].Clin Rheumatol, 2017, 36:879-884. doi: 10.1007/s10067-017-3566-0
[4]	Li Y, Cheng H, Zuo XB, et al. Association analyses identifying two common susceptibility loci shared by psoriasis and systemic lupus erythematosus in the Chinese Han population[J]. J Med Genet, 2013, 50:812-818. doi: 10.1136/jmedgenet-2013-101787
[5]	Astudillo L, Sailler L, Carreiro M, et al. Psoriasis and systemic lupus erythematosus:a rare association with specific therapeutic problems[J]. Ann Med Interne (Paris), 2003, 154:3-6. http://europepmc.org/abstract/MED/12746653
[6]	Sugiura K, Shoda Y, Akiyama M. Generalized pustular psoriasis triggered by amoxicillin in monozygotic twins with compound heterozygous IL36RN mutations:comment on the article by Navarini et al[J]. J Invest Dermatol, 2014, 134:578-579. doi: 10.1038/jid.2013.354

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