皮肌炎合并食管黏膜剥脱1例

皮肌炎(dermatomyositis，DM)是一种特发性炎症性肌病，以慢性近端骨骼肌无力、独特的皮肤损害为特征。皮肌炎合并食管黏膜剥脱临床上少见。1例36岁男性患者因“四肢肌肉酸痛、吞咽困难及咽痛”入院，被诊断为DM合并食管黏膜剥脱。患者经过糖皮质激素、免疫抑制剂、针灸及内镜黏膜下剥离术(endoscopic submucosal dissection，ESD)治疗，上述症状消失。在3年的随访期内，常规体检、实验室检查、胃镜检查和影像学检查结果均正常。此类患者治疗初期需使用大剂量糖皮质激素，之后应逐渐减量以避免激素不良反应。另外，针灸和ESD作为辅助治疗手段亦有一定效果。

Dermatomyositis with exfoliation of esophageal mucosa: A case report

Dermatomyositis (DM) is a kind of idiopathic inflammatory myopathy characterized bychronic proximal skeletal muscle weakness and unique skin lesions. However, DM withexfoliation of esophageal mucosa is rare. A 36-year-old male patient complained ofmuscular soreness of extremities, dysphagia, and pharyngalgia was diagnosed with DMwith exfoliation of esophageal mucosa. After treatment with glucocorticoid,immunosuppressant, acupuncture, and endoscopic submucosal dissection (ESD), the abovesymptoms were disappeared. During the 3-year follow-up period, the results of routinephysical examination, laboratory examination, gastroscopy, and imaging examination werenormal. High-dose of corticosteroid is needed in the initial treatment, but it must bereduced regularly to avoid adverse reactions. Acupuncture and ESD are also effective asadjuvant therapy.