Generalized pustular psoriasis. A report on thirteen patients.
Generalized pustular psoriasis. A report on thirteen patients.
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全身性脓疱型银屑病。
DOI：
10.2340/0001555556139147
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发表时间：
1976
影响因子：
3.6
通讯作者：
O. Groth
中科院分区：
文献类型：
--
作者：
S. Lindgren;O. Groth
泛发性脓疱型银屑病表现出一种波动模式，其病程随时间和患者的不同而变化。因此，预后和治疗结果极难评估。我们对这一系列中的患者进行了关于疾病自然病程的随访，包括并发症和诱发因素。令人惊讶的是，口服药物治疗经常引发急性脓疱性皮疹，这些患者也惊人地经常和迅速地对局部应用产生接触性过敏。长期全身皮质类固醇治疗的不良影响已在本系列中得到证实，主要是严重的反弹现象，尽管这种治疗已被证明是迅速扭转危及生命的状态的唯一手段。甲氨蝶呤和羟基脲的效果有时很好，但并不罕见，一般，有时甚至毫无用处。大剂量的抗生素也未能达到其他人所描述的效果。相反，乙型溶血性链球菌的继发感染在几个病例中造成了严重的问题。除了小心预防感染和诱发因素，几乎不能影响泛发性脓疱型银屑病的病程，但在严重发作期间，在新的治疗路线出现之前，使用细胞抑制剂是合理的。
Generalized pustular psoriasis shows a fluctuating pattern, its course varying with time and from patient to patient. The prognosis and results of treatment are therefore extremely difficult to assess. The patients in this series have been followed up by us with regard to the natural course of the illness including complications and precipitating factors. Oral drug therapy has suprisingly often provoked acute pustular eruptions, and these patients have also strikingly often and rapidly developed contact allergy to topical applications. The undesirable effects of long-term systemic corticosteroid therapy have been confirmed in this series, chiefly by severe rebound phenomena, notwithstanding that such treatment has proved the only means of rapidly reversing life-threatening states. The effects of methotrexate and hydroxyurea were at times good but, not uncommonly, mediocre and occasionally even useless. Large doses of antibiotics have also failed to achieve the results described by others. On the contrary, secondary infection with beta-hemolytic streptococci has caused serious problems in several cases. Apart from careful protection from infection and precipitating factors, little can be done to influence the course of generalized pustular psoriasis, but trial with cytostatics is justified during severe bouts, pending the appearance of new lines of therapy.