系统性红斑狼疮皮肤损害临床分析

系统性红斑狼疮(ＳＬＥ)是一组多器官受累的免疫性疾病,初发症状常为皮损、发热、关节疼痛,三者可同时出现,也可单独发生。为进一步探讨ＳＬＥ病人皮损与各系统受损的关系,我们对ＳＬＥ病人有无皮损发生进行了比较。结果报告如下。一般资料　1986年～1995年住院病人共200例,符合美国风湿病学会1982年ＳＬＥ诊断标准,其中有皮损者125例,男9例,女116例,年龄14～58岁,平均21.4岁。无皮损者共75例,男6例,女69例,年龄14～65岁,平均31.7岁,两组病人的年龄、性别差异无显著性意义。临床表现　发病初期首发有皮损者57例,占45.6%,皮损包括蝶性红斑、…     

系统性红斑狼疮228例临床分析

目的探讨系统性红斑狼疮患者男女临床特点及预后。方法对228例系统性红斑狼疮住院患者进行回顾性分析。结果患者男25例,女203例,男女比例1:8.12,平均发病年龄(32.72±13.49)岁(6~71岁),平均病程(2.33±2.82)年(20d~10年);男性组肾脏损害、口腔溃疡、神经系统损害、血小板减少、抗Sm抗体阳性较女性组多见(P<0.05),而女性组则以蝶形红斑、关节受累、雷诺现象、抗SSA阳性较多见(P<0.05);经治疗女性组好转率(83.74%)较男性组(60.00%)高(P<0.05),死亡率(5.42%)则较男性组(16.00%)低(P<0.05)。结论 SLE患者男女临床表现、实验室检查及预后有一定差别,与女性相比,男性内脏损害发生率较高且预后较差,临床应引起重视。     

316例女性系统性红斑狼疮患者临床表现及实验室回顾性分析

探讨316例女性系统性红斑狼疮(SLE)住院患者的临床表现及实验室检查结果是否具有差异性.收集武汉大学人民医院皮肤性病科2005-2008年316例住院女性SLE患者病案资料,用SPSS 13.0软件进行统计学分析.结果显示316例患者中,未婚年龄组面部红斑、肾脏损害、浆膜积液和白细胞升高四项指标较之已婚生育年龄组和围绝经期及其以上年龄组有统计学差异;未婚年龄组肾脏损害和浆膜积液发生率低于后两组,而白细胞升高和面部红斑发生率高于后两组.已婚生育年龄组和围绝经期及其以上年龄组SLE患者临床表现和实验室检查结果没有明显统计学差异.未婚年龄组女性SLE患者与已婚生育年龄组和围绝经期及其以上年龄组部分临床表现和实验室检查结果存在差异性,对SLE病因学研究和临床治疗有部分参考价值.     

73例亚急性皮肤型红斑狼疮患者临床分析

探讨亚急性皮肤型红斑狼疮（SCLE）患者的临床特征。对近8年我院门诊或住院的73例SCLE患者进行临床分析，并与598例系统性红斑狼疮（SLE）患者进行对照。结果：SCLE组出现光敏和抗SS—B抗体的病例明显高于SLE组，而发热、口鼻溃疡、血管损害、脱发、雷诺现象、关节痛、浆膜炎、肾损害、心脏损害、肝损害等发生率及抗核抗体（ANA）、抗双链DNA抗体（dsDNA）；抗Sm抗体、γ-球蛋白、血红蛋白、白细胞和血小板异常例数，明显低于SLE组。SCLE患者常有不同程度的全身症状及实验室阳性结果，但是较SLE患者少而轻。     

系统性红斑狼疮131例临床分析

系统性红斑狼疮(SLE)是一种多系统损害的自身免疫性疾病。本文就我院1987年～1994年10月内科收治住院的131例SLE进行临床分析。临床资料一般资料　131例SLE均符合1982年ARA的诊断标准。男11例,女120例,男女之比为1∶11。年龄12～70岁,平均35.2岁。发病年龄16～35岁者81例(61.8%),病程3天～26年,病程<3年者78例(59.8%)。首发症依次为发热(31.0%)、关节痛(26.7%)、面部皮疹(15.3%)、肾脏损害(13.7%)、胸腔积液(12.9%)、雷诺征(9.2%)。临床表现1.发热:54例(41.2%),其中43例(76.6%)为不明原因持续高热,可长达5～6个月,体温波动在39℃～40℃…     

52例少儿系统性红斑狼疮患者的临床分析

通过对５２例少儿系统性红斑狼疮患者及１５０成人患者临床资料分析，发现少儿组首发症状明显，其中枢神经损害高于成人组，从发病到中枢神经系统出现症状的平均时间短于成人组；肾脏受累发生率两组无显著差异，但其受累的严重程度明显高于成人组，痤发病到出现肾脏损害的平均时间明显短于成人组，少儿组补体Ｇ３降低发生率明显高于成人组；治疗效果较成人差。     

系统性红斑狼疮165例临床分析

目的：探讨165例SLE住院患者的临床特点。方法：对165例SLE患者的临床资料进行了回顾性分析。结果：肾损害总发生率最高达78.5%。少年组蝶形红斑、肾损害、脱发等发生率较高,病情进展快,2例发生狼疮危象。老年组起病不典型,自身抗体阳性率较低。男女患者临床表现及免疫学特征无显著差异,但男性患者内脏受累较重。结论：本院165例SLE住院患者,肾损害发生率高,少年组病情进展快,老年组起病不典型,男性组症状较重。     

男性系统性红斑狼疮38例临床分析

男性系统性红斑狼疮(SLE)临床上较少见，为提高对男性SLE的认识，我们将1997-2002年在本院住院治疗的38例男性SLE和同期住院的125例女性SLE的临床资料进行了比较，现分析如下。     

系统性红斑狼疮特异性皮损的临床意义(141例系统性红斑狼疮分析)

作者分三组(慢性盘状皮肤LE,急性皮肤LE和无皮损)分析141例SLE病人的临床、实验室检查及免疫学指标,发现有盘状LE损害的病人肾病发生率低,内脏损害轻;而无皮损病人肾病发生率高,内脏损害重。认为盘状皮损可作为SLE病情较轻的一个指标。     

系统性红斑狼疮474例临床分析

系统性红斑狼疮４７４例临床分析苏尚焙我院自１９８３年～１９９３年共收治系统性红斑狼疮（ＳＬＥ）５０８例，其中资料较完整、诊断明确者４７４例，现分析如下。１临床资料１．１一般资料：４７４例患者的诊断均符合１９８２年ＡＲＡ的诊断标准；其中男５８例，女４１...     

系统性红斑狼疮408例临床和免疫学回顾性分析

目的：分析408例系统性红斑狼疮（SLE）患者的临床和免疫学指标特点。方法：建立2004--2007年南京医科大学第一附属医院408例SLE住院患者临床资料数据库,并且用SPSS13．0软件对数据进行分析。结果：408例SLE患者脏器损害中肾脏损害最常见,达82．1％,免疫学指标中抗核抗体（ANA）阳性最常见,达91．9％。而≥50岁患者的肺部受累或视觉障碍发生明显多于〈50岁组患者,蝶形红斑、盘状红斑、发热、ds—DNA抗体阳性率以及疾病活动指数≥9的发生率明显低于〈50岁组患者。男性组患者肾损害和低蛋白血症发生率明显高于女性组患者,而光敏感的发生率则明显低于女性组患者。结论：SLE是多系统、多脏器受累的疾病,在临床症状和免疫学指标上有其特征性改变,因而重视早期诊断,对延缓SLE患者病情发展,改善预后具有重要意义。     

Comparative analysis of subacute cutaneous lupus erythematosus and chronic cutaneous lupus erythematosus: clinical and immunological study of 270 patients

Background Lupus erythematosus (LE) is a chronic, autoimmune disease resulting from an interaction of genetic, environmental and hormonal factors and characterized by a spectrum of clinical forms with variable evolution from a localized cutaneous form to a life‐threatening systemic form. Objective To analyse and compare the prevalence and characteristics of the main clinical and immunological manifestations of subacute cutaneous LE (SCLE) and chronic CLE (CCLE). Methods A total of 270 patients with CLE (112 patients with SCLE and 158 patients with CCLE) were studied retrospectively. The clinical and serological characteristics of all the patients were collected in a chart review. Results The patients with SCLE had a higher prevalence of annular and papulosquamous lesions, Raynaud phenomenon, mucous membrane ulcers, malar rashes, photosensitivity, vasculitis and a lower frequency of discoid lesions and alopecia compared with patients with CCLE. Patients with SCLE had a higher prevalence of arthralgias (P < 0·001), xerophthalmia (P = 0·045), arthritis (P < 0·001), nephropathy (P = 0·003) and systemic LE (SLE) (P < 0·001) compared with patients with CCLE. Patients with SCLE also had a higher frequency of laboratory and serological abnormalities than patients with CCLE. Generalized discoid LE (DLE) was associated with a higher prevalence of photosensitivity (P < 0·001), panniculitis (P = 0·009) and SLE (P = 0·003) than localized DLE. In patients with SCLE and those with CCLE, photosensitivity, arthralgias, arthritis, nephropathy and xerophthalmia were associated with SLE. In patients with SCLE, significant correlations existed between clinical and immunological data. Conclusions In our series, differences in the expression of CCLE and SCLE were found with respect to the distribution and type of lesions, systemic features and immunological findings.     

Recent advances in cytokines in cutaneous and systemic lupus erythematosus

Lupus erythematosus (LE) includes a broad spectrum of diseases from a cutaneous‐limited type to a systemic type. Systemic lupus erythematosus (SLE) is a systemic autoimmune disease which affects multiple organs. Cutaneous lupus erythematosus (CLE) includes skin symptoms seen in SLE and cutaneous‐limited LE. Although immune abnormalities, as well as heritable, hormonal and environmental factors, are involved in the pathology of LE, the actual pathogenesis is still unclear. Recently, the involvement of various cytokines has been shown in the pathogenesis of LE. Moreover, some trials with biological agents targeted specific cytokines are also ongoing for SLE. In this article, we review the contributions of major cytokines such as interferon, tumor necrosis factor‐α and interleukin‐18 to LE, especially SLE and CLE.     

167例系统性红斑狼疮患者的临床及胸部影像学分析

目的：分析系统性红斑狼疮(SLE)患者的临床及胸部影像学改变，提高对本病的认识：方法：分析了167例确诊为SLE患者的临床及胸部X线平片改变．包括26例患者的CT片分析。结果：167例患者中胸部X线异常者89例(53．3％)，主要表现为双肺、心脏、胸膜和膈肌的改变。其中两种或两种以上改变并俘者65例(38．9％)。26例胸部CT检查均显示异常。部分影像学改变早于临床表现。结论：XLE的胸部X线及CT检查对早期胸部病变的诊断有参考价值，但由于相对缺乏特异性，需结合临床及实验室检查综合判断。     

208例SLE临床和免疫学特征分析

为探讨皮肤科门诊定期就诊的SLE患者临床特征，自身抗体分布及长期皮质类固醇治疗引起的副作用，统计分析了208例SLE的首发症状及病程中临床表现和自身抗体分布情况，并分年龄、性别组进行分析，比较。结果：所有患者一般特征，临床表现和免疫学特征和国内外报道基本一致，首发症状为蝶形红斑者占60.58%，少年组及年轻男性组内脏受累重，皮类固醇副作用以浅表真菌感染最常见。     

The value of lymphocytopenia as a marker of systemic involvement in cutaneous lupus erythematosus

BACKGROUND: Some patients suffering from cutaneous lupus erythematosus (CLE) develop extracutaneous manifestations during the course of the disease: up to 5% of patients with discoid LE (DLE) and up to 30% of subacute cutaneous LE (SCLE) patients show systemic involvement. Recent studies revealed some markers indicating systemic manifestations of CLE patients. However, the significance of diminished peripheral lymphocyte numbers as a marker of systemic involvement in CLE has not been investigated before. OBJECTIVES: To determine the value of lymphocytopenia (< 1500 cells microL(-1)) as a marker of extracutaneous manifestations in CLE patients. : Methods The records of 72 CLE patients (44 DLE; 28 SCLE) were investigated. Systemic involvement was defined in accordance with the criteria of the European Academy of Dermatology and Venereology. Analyses of peripheral lymphocyte numbers were done by fluorescence-activated cell sorter analysis. RESULTS: Five CLE patients developed extracutaneous manifestations during the course of disease. All these patients were lymphocytopenic. Differences between peripheral lymphocyte numbers of CLE patients with and without additional systemic involvement were highly significant (P < 0.01). CONCLUSIONS: Our results suggest that lymphocytopenia in patients with CLE is a high sensitive but low specific marker of systemic involvement.     

Follicular lupus erythematosus: a new cutaneous manifestation of systemic lupus erythematosus

Summary We report the clinical, histopathological and immunological features of follicular erythema and petechiae in a 30-year-old Japanese woman with systemic lupus erythematosus (SLE). Histology showed this eruption to constitute a cutaneous manifestation of SLE. To our knowledge, this is the first reported case of follicular erythema and petechiae in association with SLE. Accordingly, we propose that this rare eruption be termed 'follicular lupus erythematosus'.