[1]拓惠惠,郑焱,张婧,等.反应性穿通性胶原病28例临床分析[J].中国皮肤性病学杂志,2021,(09):1001-1006.[doi:10.13735/j.cjdv.1001-7089.202011034]
 TUO Huihui,ZHENG Yan,ZHANG Jing,et al.Clinical Analysis of 28 Patients with Reactive Penetrating Collagenosis[J].The Chinese Journal of Dermatovenereology,2021,(09):1001-1006.[doi:10.13735/j.cjdv.1001-7089.202011034]
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反应性穿通性胶原病28例临床分析()
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《中国皮肤性病学杂志》[ISSN:1001-7089/CN:61-1197/R]

卷:
期数:
2021年09期
页码:
1001-1006
栏目:
临床经验
出版日期:
2021-09-01

文章信息/Info

Title:
Clinical Analysis of 28 Patients with Reactive Penetrating Collagenosis
文章编号:
1001-7089(2021)09-1001-06
作者:
拓惠惠郑焱张婧王宁杨鹏举杨雅杰杜文倩孙妍冯义国
西安交通大学第二附属医院皮肤科,陕西 西安 710004
Author(s):
TUO HuihuiZHENG YanZHANG JingWANG NingYANG PengjuYANG YajieDU WenqianSUN YanFENG Yiguo
(Department of Dermatology,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)
关键词:
反应性穿通性胶原病 临床特点 伴随疾病 治疗方法
Keywords:
Reactive penetrating collagenosis Clinical characteristics Concomitant disease Treatment
分类号:
R 758.6
DOI:
10.13735/j.cjdv.1001-7089.202011034
文献标志码:
A
摘要:
目的 探讨反应性穿通性胶原病(reactive penetrating collagenosis,RPC)的临床表现、伴随疾病以及治疗反应。方法 回顾性分析西安交通大学第二附属医院2014年11月-2020年8月经组织病理确诊的28例RPC患者的病史、皮损特点、伴随疾病、家族史及治疗反应等资料。结果 28例患者的平均发病年龄为44岁,病程中位数为1年,发病无性别差异,且均无家族史。皮损最常见于下肢(85.71%),常为多发(89.29%),但也可单发于阴囊、腰背部及足部等。表现为瘙痒或疼痛性红斑、丘疹、溃疡,边缘堤状隆起,中央凹陷上覆不易剥离的角栓,可伴有同形反应(14.29%)。12例(42.86%)患者合并一种或多种其他系统疾病,以糖尿病、高血压、慢性肾衰竭为主。组织病理可见变性胶原纤维从表皮垂直穿出。治疗主要为控制原发病、抗炎、抗感染、对症、抑制异常角化等。除3例患者手术切除后缓解及1例失访者外,其余24例药物治疗者中仅12例(50.00%)治愈,随访无复发。结论 RPC临床较少见,皮损常多发于双下肢,但也可单发于特殊部位或局限于单侧肢体。儿童发病可为特发性或遗传性,成人发病多为获得性,也可无伴随疾病,其发病机制不清,尚无特效治疗方法。
Abstract:
Objective To investigate the clinical manifestations,concomitant diseases and therapeutic reaction of reactive penetrating collagenosis(RPC). Methods The medical history,skin lesion characteristics,concomitant diseases,family history and therapeutic reaction of 28 RPC patients diagnosed by histopathology in the Second Affiliated Hospital of Xi'an Jiaotong University from November 2014 to August 2020 were retrospectively analyzed. Results The mean age of onset of the 28 patients was 44 years old,and the median course of disease was one year. There was no gender difference in terms of onset of disease,and none of them had a family history. Skin lesions were most common on lower extremities(85.71%),and mostly multiple(89.29%),but single lesions could also be found on scrotum,lower back and feet. Clinical manifestations were pruritus or painful erythema,papule,ulcer,peripheral bulges and central depression covered with hard-to-remove keratinization, which might be accompanied by Koebner's phenomenon(14.29%). Twelve patients(42.86%)had one or more other systemic diseases,mainly diabetes mellitus,hypertension and chronic renal failure. Histopathology showed the denatured dermal collagen penetrated vertically from the epidermis. The treatment mainly included the treatment of primary disease,anti-inflammatory,anti-infection and symptomatic treatment,and inhibition of abnormal keratosis. In addition to three patients with remission after surgical resection and one patient who was lost to follow-up,only 12(50.00%)of the remaining 24 patients were cured and no recurrence was found during follow-up. Conclusion RPC is a rare disease. The skin lesions usually occur on both lower extremities,but also can be single lesions on specific areas or confined to one limb. The disease can be idiopathic or hereditary in children,and mostly acquired in adults,with or without accompanying diseases. The pathogenesis is unclear,and there is no specific treatment.

参考文献/References:

[1] García-Malinis AJ,Del Valle Sánchez E,Sánchez-Salas MP,et al.Acquired perforating dermatosis:clinicopatholo-gical study of 31 cases,emphasizing pathogenesis and treatment[J].J Eur Acad Dermatol Venereol,2017,31(10):1757-1763.
[2] Ramesh V,Sood N,Kubba A,et al.Familial reactive perforating collagenosis:a clinical,histopathological study of 10 cases[J].J Eur Acad Dermatol Venereol,2007,21(6):766-770.
[3] Kreuter A,Gambichler T.Acquired reactive perforating collagenosis[J].Can Med Assoc J,2010,182(4):E184.
[4] Bong JL,Fleming CJ,Kemmett D.Reactive perforating collagenosis associated with underlying malignancy[J].Br J Dermatol,2000,142(2):390-391.
[5] Kochen D,Sohal RJ,Nat A.Reactive perforating collage-nosis; an uncontrolled pruritus that left you scratching your head[J].Cureus,2020,12(7):e9175.
[6] Escudero-Góngora MM,Del Pozo LJ,Knöpfel N,et al.Reactive perforating collagenosis on a tattoo[J].J Eur Acad Dermatol Venereol,2017,31(2):e87-e89.
[7] Kawakami T,Saito R.Acquired reactive perforating collagenosis associated with diabetes mellitus:eight cases that meet Faver's criteria[J].Br J Dermatol,1999,140(3):521-524.
[8] Singhania N,Singhania G,Al-Rabadi L.Acquired reactive perforating collagenosis[J].Clin Exp Nephrol,2020,24(11):1086-1087.
[9] Murase Y,Takeichi T,Tanahashi K,et al.Acquired reactive perforating collagenosis with chondrodermatitis nodularis chronica helicis[J].J Dermatol,2020,47(10):e362-e364.
[10] Kawakami T,Soma Y,Mizoguchi M,et al.Immunohistochemical analysis of transforming growth factor-beta3 expression in acquired reactive perforating collagenosis[J].Br J Dermatol,2001,144(1):197-199.
[11] Faver IR,Daoud MS,Su WP.Acquired reactive perforating collagenosis.Report of six cases and review of the literature[J].J Am Acad Dermatol,1994,30(4):575-580.
[12] Satti MB,Aref AH,Raddadi AA,et al.Acquired reactive perforating collagenosis:a clinicopathologic study of 15 cases from Saudi Arabia[J].J Eur Acad Dermatol Venereol,2010,24(2):223-227.
[13] Miyanaga M,Oyama N,Sakai Y,et al.Successful treatment of acquired reactive perforating collagenosis with topical benzoyl peroxide:A possible therapeutic action underlying structural and metabolic turnover[J].J Dermatol,2020,47(1):e12-e14.
[14] Zhang X,Yang Y,Shao S.Acquired reactive perforating collagenosis:A case report and review of the literature[J].Medicine(Baltimore),2020,99(22):e20391.
[15] Tsai TF,Yeh TY.Allopurinol in dermatology[J].Am J Clin Dermatol,2010,11(4):225-232.
[16] Querings K,Balda BR,Bachter D.Treatment of acquired reactive perforating collagenosis with allopurinol[J].Br J Dermatol,2001,145(1):174-176.

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备注/Memo

备注/Memo:
[通信作者] 冯义国,E-mail:fengyiguo70@163.com
更新日期/Last Update: 2021-09-01