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亚急性皮肤型红斑狼疮早期症状是什么样的?该如何判断?

2019-2-20 14:23| 发布者: admin| 查看: 3963| 评论: 149

简介:亚急性皮肤型红斑狼疮占红斑狼疮的10%~15%,较少累及肾和中枢神经系统等,预后相对较好,严重程度介于盘状红斑狼疮和系统性红斑狼疮之间。亚急性皮肤型红斑狼疮的皮肤损害广泛分布于面、颈、躯干、肩部,并可扩及前臂和 ...
    亚急性皮肤型红斑狼疮占红斑狼疮的10%~15%,较少累及肾和中枢神经系统等,预后相对较好,严重程度介于盘状红斑狼疮和系统性红斑狼疮之间。亚急性皮肤型红斑狼疮的皮肤损害广泛分布于面、颈、躯干、肩部,并可扩及前臂和手背。亚急性皮肤型红斑狼疮有两种特征性皮损,分别为环形红斑和丘疹鳞屑样皮损。环形红斑样皮损好发于面部,也可见于躯干或四肢。皮损初为浸润性红斑,后逐渐向外扩大,中心逐渐愈合,无或有少许鳞屑,愈后遗留色素沉着。

亚急性皮肤型红斑狼疮早期症状是什么样的?该如何判断?65 作者: 来源:


    丘疹鳞屑样皮损分布较广泛,好发于暴露部位。皮损为红色丘疹和斑疹,表面有鳞屑。多数患者对日光过敏,常伴关节痛、低热和肌肉痛等症状,有时可伴浆膜炎,但严重的肾和中枢神经系统受累较少。约50%亚急性皮肤型红斑狼疮患者符合美国风湿学会系统性红斑狼疮的诊断标准。环形红斑型亚急性皮肤型红斑狼疮病情一般较稳定,不易转化为系统性红斑狼疮。而部分丘疹鳞屑型亚急性皮肤型红斑狼疮患者则易发展为系统性红斑狼疮。

    亚急性皮肤型红斑狼疮可有白细胞减少、血小板减少、红细胞沉降率增加、免疫球蛋白增高等。约80%患者抗核抗体阳性,60%~70%患者抗 Ro/SSA抗体和抗 La/SSB抗体阳性,后两种抗体被认为是亚急性皮肤型红斑狼疮的标志抗体,其中,环形红斑型抗 La/SSB抗体阳性率更高。

亚急性皮肤型红斑狼疮早期症状是什么样的?该如何判断?61 作者: 来源:


    本病根据典型临床表现结合免疫学检查一般不难诊断。丘疹鳞屑型亚急性皮肤型红斑狼疮需与银屑病进行鉴别,环形红斑型亚急性皮肤型红斑狼疮则需与环形红斑和 Sweet综合征等进行鉴别。

    亚急性皮肤型红斑狼疮的治疗以内服药物为主,糖皮质激素、沙利度胺、羟氯喹,还有其他,如氨苯砜、雷公藤多苷等。外用药物治疗可酌情用糖皮质激素霜剂。亚急性皮肤型红斑狼疮活动期应注意适当休息,缓解期可从事适度工作,但勿过度劳累,尽量避免日晒。
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