摘要
目的:探讨关节病性银屑病的临床特点及治疗。方法:对29例关节病性银屑病患者的临床资料进行回顾性分析。结果:本组病例平均发病年龄31.4岁,男18例、女11例,男∶女为1.64∶1。以皮损为首发者20例(69.0%),关节炎首发者6例(20.7%),皮损和关节炎同时发生者3例(10.3%);皮损类型为寻常型27例(93.1%),脓疱型1例(3.4%),红皮病型1例(3.4%);关节炎分类为非对称性少关节炎型10例(34.5%),远端指(趾)间关节炎型7例(24.1%),脊柱关节病型6例(20.7%),对称性多关节炎型4例(13.8%),残毁性关节炎型2例(6.9%);25例患者接受关节X线检查,其中20例有阳性改变,表现为关节间隙变窄、骨质疏松、骨质吸收和骨刺形成。结论:本病男性多发,各型银屑病皮损都可并发关节炎病变。非对称性少关节炎和远端指(趾)关节易受累是本病的特点。甲氨蝶呤、来氟米特、阿维A、雷公藤多苷、沙利度胺、环孢素、吗替麦考酚酯、非甾体类抗炎药、小剂量糖皮质激素等合理联合用药可取得较好疗效。
Objective： To analyze the clinical features and treatment of psoriatic arthritis （PsA）. Methods： The clinical data of 29 patients with PsA were analyzed retrospectively. Results： Among the 29 patients, the average age of onset was 31.4 years old, and the ratio of male to female was 1.64 ： 1. The skin lesions manifested prior to arthritis in 20 cases（69.0%）, arthritis prior to skin lesions occurred only in 6 cases（20.7%）, and both symptoms of skin and joints appeared simultaneously in 3 cases（10.3%）. The skin lesions could be classified into 3 types： psoriasis vulgaris （93.1%, 27/29）, generalized pustular psoriasis （3.4%, 1/29） and psoriatic erythroderma（3.4%, 1/29）. As for the types of arthritis, 10 cases （34.5%） were asymmetrical arthritis of major joints, 7 cases （24.1%） distal interphalangeal arthritis, 6 cases （20.7%） spondyloarthropathy, 4 cases （13.8%） symmetrical arthritis of multiple joints and 2 cases （6.9%） mutilation patterns. Twenty-five patients received X-ray examinations, of which 20 revealed joint damages. The common radiological findings were narrowing of joint space, osteoporosis, erosive changes and spur formation. Conclusions： The male patients outnumber the females. The inflammatory arthropathy can be observed in all the types of psoriasis. Asymmetrical, multiple and distal interphalangeal arthritis are characteristic for PsA. Methotrexate, leflunomide, etretinate, Tripterygium wilfordii, thalidomide, cyclosporine, mycophenolate mofetil, NSAIDs, low doses of corticosteroids used in combination might have effective results in the management of PsA.
出处
《临床皮肤科杂志》
CAS
CSCD
北大核心
2007年第11期688-690,共3页
Journal of Clinical Dermatology
