摘要
患者男,18岁。全身红斑、鳞屑10余年,加重4年,组织病理符合银屑病。有长期服用糖皮质激素类药物史,继发外源性库欣综合征。治疗方面,逐渐减停激素类药物,将氢化可的松由10mg 2次/d口服经半年时间逐渐减停。予阿维A 20mg 2次/d口服2个月后,减量至30mg 1次/d口服8个月至今。服用阿维A 7个月时,为加强疗效、辅助撤退激素、防止复发,加用环孢素软胶囊50mg 2次/d口服2个月,后减量为25mg 3次/d口服两周。经10个月治疗后,患者库欣综合征表现及全身皮损改善明显。从本例可以看出,长周期应用阿维A对于红皮病型银屑病并发外源性库欣综合征患者,在辅助撤退激素和改善全身皮损方面疗效肯定。对于急需控制病情和需要减停激素的患者,可考虑使用联合疗法。
An 18-year-old male patient was diagnosed with erythrodermic psoriasis,with a complaint of diffuse erythema and superficial exfoliation involving most of the body surface area for over ten years and exacerbation for four years. Histopathologic examination confirmed the diagnosis of psoriasis. A long time use of hydrocortisone induced exogenous Cushing syndrome. The hydrocortisone was gradually suspended from 10 mg bid in half a year. The patient has been treated with acitretin 20 mg bid for two months and then 30 mg qd for eight months until now. To enhance the therapy,assist in suspending hydrocortisone and prevent relapse,we added cyclosporin A 50 mg bid for two months and then 25 mg tid for two weeks three months ago. After the tenmonth treatment of acitretin and cyclosporin A,both the symptoms of Cushing syndrome and the skin lesions were improved remarkably. From this case,we conclude that long-period acitretin using may have certain effect for patients with erythrodermic psoriasis and exogenous Cushing syndrome to improve skin lesions and help suspending glucocorticoids. Combination therapy can be considered for the patients who are in urgent need of disease control and suspending glucocorticoids.
出处
《中国皮肤性病学杂志》
CAS
CSCD
北大核心
2016年第3期328-330,共3页
The Chinese Journal of Dermatovenereology
关键词
红皮病型银屑病
库欣综合征
阿维A
环孢素
组织病理
Erythrodermic Psoriasis
Exogenous cushing syndrome
Acitretin
Cyclosporin A
Histopathology
