Keratosis follicularis squamosa (Dohi) successfully treated with benzoyl peroxide 2.5% gel
Keratosis follicularis squamosa (Dohi) successfully treated with benzoyl peroxide 2.5% gel
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角化%20毛囊%20鳞状%20(土肥)%20成功%20治疗%20用%20苯甲酰%20过氧化物%202.5%%20凝胶
DOI：
10.1111/1346-8138.14128
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
H. Amano
中科院分区：
文献类型：
--
作者：
S. Mori;T. Akasaka;H. Amano
亲爱的编辑，毛囊鳞状角化病（KFS），首先由土肥在1903年描述，是一种角质化疾病。KFS在亚洲人中特别常见。来自衣物的刺激、细菌感染、遗传和激素失衡被认为是致病因素。然而，KFS的真实的发病机制仍不清楚。我们在此报告一例成功治疗KFS外用过氧化苯甲酰（BPO）2.5%凝胶。1例10岁日本女孩，躯干和腹股沟区出现无症状褐色鳞屑斑片6个月（图1a，B）。外用类肝素软膏、皮质类固醇软膏、口服维生素C和氨甲环酸治疗无效。她的病史无异常，既往无特应性皮炎病史。没有类似情况的家族史。体格检查显示小的散在圆形或椭圆形糠疹斑片，中央有褐色滤泡栓（图1c）。这片看起来像荷叶上的水所描述的土肥和Momose在他们的第一份报告，这种疾病。皮肤镜下观察回声胶样病变，可见中央典型的褐色毛囊栓（图1d）。组织学检查显示毛囊扩张伴角化栓和角化过度（图1e）。革兰氏染色显示毛囊中有革兰氏阳性球菌（图1g）。根据以上发现，我们诊断她患有KFS。每天使用一次局部BPO凝胶后，她在4周内表现出明显的临床改善。治疗8周后，皮肤病变明显改善（图1g）。没有严重的不良反应，局部BPO凝胶注意到在过程中。在已发表的工作中，已尝试局部尿素、水杨酸和维生素D软膏作为KFS的治疗，然而，没有良好的治疗结果的报道。据我们所知，这是第一次报告的KFS成功地治疗外用BPO凝胶。已知过氧化苯甲酰是一种强氧化剂。它减少了皮肤表面的微生物数量
Dear Editor, Keratosis follicularis squamosa (KFS), first described by Dohi in 1903, is a keratinizing disorder. KFS is particularly common in Asians. Irritation from clothing, bacterial infections, heredity and hormone imbalances have been proposed as pathogenic factors. However, the real pathogenesis of KFS is still unknown. We herein report a case of KFS successfully treated with topical benzoyl peroxide (BPO) 2.5% gel. A 10-year-old Japanese girl presented with a 6-month history of asymptomatic brownish scaly patches on her trunk and inguinal regions (Fig. 1a,b). Therapy with topical heparinoid ointment, corticosteroid ointment, oral vitamin C and tranexamic acid were not effective. Her medical history was unremarkable and she had no past history of atopic dermatitis. There was no family history of a similar condition. Physical examination revealed small scattered pityriatic round or oval patches with a brownish follicular plug in the center (Fig. 1c). This patch looked like lotus leaves on water as described by Dohi and Momose in their first report of this disease. Dermoscopic observation of the lesion with echo-jelly showed a typical brownish follicular plug in the center (Fig. 1d). Histological examination of her patch revealed dilated follicles with keratotic plugs and orthohyperkeratosis (Fig. 1e). The Gram stain showed Gram-positive cocci in the hair follicles (Fig. 1g). Based on the above findings, we diagnosed her as having KFS. After topical BPO gel was initiated once a day, she showed marked clinical improvement within 4 weeks. Eight weeks of therapy resulted in a marked improvement of the skin lesions (Fig. 1g). No serious adverse effects of topical BPO gel were noted during the course. Topical urea, salicylic acid and vitamin D ointment have been tried in the published work as treatments for KFS, however, no good therapeutic results were reported. To the best of our knowledge, this is the first report of KFS successfully treated with topical BPO gel. Benzoyl peroxide is known to be a powerful oxidizing agent. It reduces the number of microorganisms on the skin surface