阿维A治疗泛发型连续性肢端皮炎1例

报道1例泛发型连续性肢端皮炎患者，予阿维A 30mg/d治疗3周后，全身皮损基本消退，仅双手10指仍见脓疱。随后将阿维A减20mg/d，并加用PUVA治疗2周，患者痊愈。     

泛发性连续性肢端皮炎1例

报告1例泛发性连续性肢端皮炎。患者男,42岁。双手甲部脓疱、浑浊、增厚6年,全身反复红斑、脓疱3年,加重1月。组织病理检查示Kogoj微脓肿及炎性细胞浸润。诊断:泛发性连续性肢端皮炎。     

泛发性连续性肢端皮炎1例

患者女,35岁。双手足反复起脓疱、糜烂伴疼痛26年,泛发加重6天。体检发现躯干、四肢片状水肿性红斑,其上可见簇集分布的脓疱。双手足可见片状红斑、糜烂,部分表面覆黄色痂皮及散在分布的粟粒大脓疱。双手指甲可见甲周红肿,部分甲下积脓、覆黄色厚痂,甲板缺失、指甲脱落,远端指骨萎缩。可见沟纹舌。诊断:泛发性连续性肢端皮炎。     

泛发性连续性肢端皮炎1例

1 病历摘要 患者男,21岁.自述于2岁时,因外伤致其右手示指指甲脱落,未予治疗,此后该指指甲未再长出.伤后3年,即5岁时起,患者右手示指甲床开始出现脓疱疹,于当地乡村医院诊断为"化脓性骨髓炎",并予截指手术(右手示指远端第1、2指节被截除).直至15岁,该指残端及他处皮肤未再出现脓疱疹.15岁时起,患者双手指端、双足趾端及足跟部皮肤相继出现红肿和脓疱疹.曾于外院按"连续性肢端皮炎",给予维A酸类药物、中成药物(具体不详)治疗,病情时轻时重、迁延反复.19岁时起,患者肢端红肿明显加重,脓疱疹增多,同期全身皮肤于短时间内出现大量脓疱疹,部分脓疱融合成较大脓湖,伴有持续发热症状,外院曾按"脓疱性银屑病"给予糖皮质激素、维A酸等药物治疗,可使病情获得临床缓解,但停药后病情复又发作,至2011年4月6日来院就诊时,已反复发作3次.     

连续性肢端皮炎1例

报告1例连续性肢端皮炎。患者女,19岁。双手指末端红肿,出现脓疱、糜烂伴疼痛3年余。组织病理示Kogoj海绵状脓疱及炎细胞浸润。诊断:连续性肢端皮炎。予以曲安西龙、阿维A、四环素等联合治疗,获得较好效果。     

连续性肢端皮炎二例

临床资料 病例1患者,女,24岁。主因左手指红斑、脓疱、萎缩反复10余年,于2010年5月5日就诊。患者10年前无明显诱因左手拇指出现红斑、脓疱,无明显自觉症状,     

连续性肢端皮炎1例

患者男．43岁.因右手中指甲下出现红斑、脓疱4个月余,加重并泛发全身1周余,于2006年2月23日入院。4个多月前,患者右手中指被异物刺伤后甲下出现红斑、脓疱,伴灼痛,在当地医院经抗感染治疗后病情无好转,甲下反复出现小脓疱．并逐渐蔓延至该指第1～3指节及右手背。1周前躯干、四肢亦出现散在红斑．其上密集针头至米粒大脓疱,基底潮红,[第一段]     

连续性肢端皮炎1例

1临床资料 患者男,44岁,农民。双手指末端红斑、脓疱伴疼痛反复发作1年,加重1个月,于2012年1月10日来我院就诊。2年前患者左手外伤后中指端出现红斑、脓疱,脓疱浑浊增厚,反复不愈,逐渐加重,左手其他手指末端相继出现同样皮损。当地诊所考虑感染,给予抗生素治疗无效,后在卫生院诊断为湿疹,给予皮炎平软膏外用,口服扑尔敏片,症状减轻,但未彻底治愈。     

连续性肢端皮炎1例

<正>1病历摘要患者男,63岁。双手指末端出现红斑及脓疱4个月,加重并蔓延全身1个月,于2016年12月12日来我院皮肤科就诊。4个月前患者右手第五指末端无明显诱因出现红斑,其上群集粟粒大脓疱,伴脓性渗出,无疼痛及瘙痒,后双手拇指末端均出现类似新发皮损。1个月前患者行右拇指拔甲治疗,后病情加重,患指原发皮损向近心端逐渐蔓延至中段,左手拇指、右手第五指指甲脱落,右侧腕部、左侧髋部、背部、右下肢散在出     

英夫利西单抗治疗脓疱性银屑病一例

患者女,25岁,9年前头皮出现红色斑块,伴鳞屑、瘙痒,外院诊断脂溢性皮炎,外用药物治疗效果欠佳。8年前全身出现点滴状红色丘疹,上覆银白色鳞屑,境界清楚,瘙痒明显,外院诊断为银屑病,予中药治疗3个月后皮疹基本消退。随后数年病情常反复,冬重夏轻。4年前病情再次加重,皮疹扩展至全身,至我院住院治疗,予强力宁针、白芍总苷片、甲氨蝶呤片（7.5 mg每周1次）治疗后,患者皮疹较前好转,瘙痒减轻……     

连续性肢端皮炎15例临床及病理分析

目的分析15例连续性肢端皮炎患者的临床表现、病程、皮肤组织病理及治疗等方面特征。方法对15例连续性肢端皮炎患者的临床资料进行回顾性分析。结果①发病年龄在（7—50）岁,好发于指（趾）、表现为指（趾）末端红肿,皮下群集性水疱、脓疱,糜烂等,可伴有甲改变及地图舌等;②病程6月至20年不等,易反复发作;③组织病理特征：表皮角化不全,棘层肥厚,皮突延长,可见Kogoj微脓肿,真皮浅层毛细血管扩张充血,管周慢性炎细胞浸润;（4）经口服阿维A胶囊、外用卡泊三醇软膏等治疗后均得到不同程度缓解。结论连续性肢端皮炎的诊断需要临床与病理的密切结合,治疗较顽固。     

连续性肢端皮炎样增生型天疱疮

报告1例发生于指趾类似于连续性肢端皮炎的增殖型天疱疮.患者男,70岁.唇部、口腔黏膜出现脓疱并增生8个月,指、趾脓疱增生1个半月.皮损组织病理检查示表皮呈假性上皮瘤样增生,基底层上方棘层松解,角质层中性粒细胞和嗜酸性粒细胞移入,可见嗜酸性脓疱形成.直接免疫荧光检查示棘细胞间近基底层IgG和C3呈网状沉积.间接免疫荧光检查不棘细胞间偏下方IgG呈网状沉积,滴度为1:10.给予中等剂量糖皮质激素治疗后皮损很快好转.     

连续性肢端皮炎继发鳞状细胞癌1例

报道连续性肢端皮炎继发鳞癌１例,其发生可能与长期局部炎症刺激和全身应用免疫抑制剂有关。     

Successful treatment for acrodermatitis continua of Hallopeau using topical calcipotriol

Summary We report a 71 year-old woman who had severe infammatory acrodermatitis continua of Hallopeau. The administration of local remedies, soft X-rays and a number of systemic treatments resulted only in transient and incomplete resolution of the lesions. The pustules, increased skin fragility, tender oedema and erythema were successfully controlled by the local administration of calcipotriol.     

Nails as immune‐privileged sites: A case of disabling Acrodermatitis continua of Hallopeau successfully treated with Apremilast

Acrodermatitis continua of Hallopeau (ACH) is a chronic, inflammatory, and relapsing disorder characterized by the progressive destruction of fingernails and toenails. This condition is rare, difficult to treat, and often misdiagnosed. Several antipsoriatic treatments have been used, without any therapeutic guideline and no real improvement. Apremilast is an oral phosphodiesterase 4 inhibitor, approved for the treatment of chronic plaque psoriasis and psoriatic arthritis. It increases the intracellular concentration of cAMP and restores cytokine equilibrium, especially IL‐10, which is particularly involved in nail psoriasis. We reported the case of a 58‐year‐old man affected by ACH, successfully treated with Apremilast, who achieved a complete healing in just 1 month of treatment without any side effect. We suggest this drug as a successful new treatment for ACH, which can improve clinical manifestations rapidly and has no or few adverse effects. Future formal clinical trials and additional case reports are needed to establish the safety and efficacy of Apremilast in the treatment of ACH.     

Infliximab for the treatment of recalcitrant generalized pustular psoriasis of pregnancy: Report of a challenging case

Pustular psoriasis of pregnancy (PPP), also known as impetigo herpetiformis, is a rare gestational dermatosis that may induce life‐threatening complications for both the mother and fetus. Treatment of recalcitrant generalized PPP may be challenging as available therapeutic options are limited. We herein present a 24‐year‐old pregnant woman with generalized PPP accompanied by high fever, fatigue, leukocytosis, and elevated levels of serum acute phase reactants. The patient was resistant to a combination treatment of high‐dose cyclosporine (7.5 mg/kg/d, peroral), systemic methylprednisolone (1 mg/kg/d, intramuscular), and empirical antibiotherapy. However, she dramatically improved with infliximab (5 mg/kg, intravenous infusion), which was introduced at week 28 of pregnancy. Even within 24 hours after the first infusion of infliximab, pustular lesions began to regress with a rapid decline in fever. Following the third infusion, clearance of pustular lesions with a slight erythema was observed. Serum levels of leukocytes and acute phase reactants returned to normal. There were no adverse events related to infliximab therapy. At 40 weeks, the patient gave birth to a healthy baby. Our experience reported herein suggests that infliximab may serve as a rapidly acting, highly effective, and well‐tolerated “rescue” therapy in recalcitrant generalized PPP, which poses a big therapeutic challenge for clinicians.     

英夫利西单抗治疗坏疽性脓皮病伴溃疡性结肠炎一例

患者女,22岁。反复脓血便伴腹痛2年,双下肢疼痛性溃疡半年。患者于2012年12月间断出现便中带血,腹泻,10次/d,伴中下腹阵发性绞痛,排便后部分缓解,症状进行性加重;结肠镜示溃疡性结肠炎,予以柳氮磺吡啶治疗2个月无缓解,后改用美沙拉嗪口服及甲泼尼龙静脉滴注（具体剂量不详）,2周后症状缓解,之后疾病反复发作。2014年4月糖皮质激素减停后再次出现淡红色血便伴腹痛,并逐渐加重……