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采用维甲酸类药物结合窄波紫外线B治疗儿童急性泛发性脓疱型银屑病
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作者 Kopp T. karlhofer f. +1 位作者 Szé pfalusi Z. 党倩丽 《世界核心医学期刊文摘(皮肤病学分册)》 2005年第3期61-61,共1页
Severe pustular psoriasis von Zumbusch type is a therapeutic challeng e not on ly in adults, but even more in children. We report a 3 1/2- year-old boy who developed a generalized flare of diffusely scattered pustules... Severe pustular psoriasis von Zumbusch type is a therapeutic challeng e not on ly in adults, but even more in children. We report a 3 1/2- year-old boy who developed a generalized flare of diffusely scattered pustules on erythematous sk in which rapidly progressed to large exuding areas. The clinical presentation an d investigations including histopathological examination of a biopsy and negativ e bacterial cultures were consistent with the diagnosis of pustular psoriasis vo n Zumbusch type. Upon initial treatment withmethylprednisolone, acitretin and an tibiotics the extent of the disease declined. However, several attempts to reduc e the dose of the oral corticosteroid were followed by immediate severe flares. Additional treatmentwith narrowband ultraviolet B (NB-UVB, 311- 313 nm UVB) r esulted in a rapid arrest of disease activity and allowed the corticosteroid to be tapered off. After 10 irradiations the patientwas both off steroid and diseas e free. NB-UVB therapy was subsequently reduced to twice-weekly exposures an d acitretin gradually diminished to a maintenance dose of 0.3 mg kg-1 daily. W e conclude that NB-UVB in conjunction with acitretin is a potent therapeutic r egimen for the treatment of severe pustular psoriasis von Zumbusch type in child hood. 展开更多
关键词 维甲酸类药物 脓疱性银屑病 泛发性 阿维 皮质类固醇激素 组织活检 细菌培养阴性 每公斤体重 播散性 皮质激素
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