摘要
目的探讨儿童闭塞性干燥性龟头炎(BXO)临床及治疗特点。方法回顾性分析6例BXO患儿临床特点、治疗及预后情况。结果 6例儿童BXO中位发病年龄7.33岁(4.5~10.25岁);中位病程12个月(4~48个月)。5例患儿有泌尿外科手术史。临床表现为龟头、包皮、尿道外口或尿道口造瘘处瓷白色色素减退性斑片,表面干燥或糜烂、出血,部分伴有毛细血管扩张,包皮弹性降低、硬化,排尿时疼痛、费力。6例患儿均有不同程度的尿流变细,其中2例患儿排尿性膀胱尿道造影为尿道远端限局性变细。6例患儿外用他克莫司软膏减轻症状,延缓病情进展,改善尿流情况。所有患儿皮损均于治疗后2~4周开始缓解,5例患儿治疗20~24周后皮损处外观基本正常。1例患儿尿流基本恢复正常,5例患儿尿流改善不显著。结论男童BXO多发生于泌尿外科手术后,皮损对外用他克莫司软膏反应良好,但尿道狭窄需考虑行泌尿外科手术。
Objective To investigate the clinical features and therapeutic effects of 6 children with balanitis xerotica obliterans （BXO）. Methods A retrospective study was carried out on 6 children with BXO. The clinical features, treatment and prognosis of the patients were analyzed. Results The median onset age of the 6 children with BXO was 7.33 years old（range, 4.5-10.25 years）, and the median clinical course was 12 months（range, 4-48 months）, 5 children had the history of urological operation. Clinically, the patients presented with porcelain-like discolouration on the glans penis, foreskin, meatus and the region of the urethrostomy. Dry or erosion, hemorrhage, and sometimes telangiectasia were found on the surface of the involved skin. The prepuce became tightened and non-retractile with difficulty in voiding. Different degrees of attenuation of urine flow was found in all the 6 children, among them voiding cystourethrography showed that the anterior urethra was stenotic in 2 children. All of the patients were treated with 0.03% tacrolimus ointment to relieve the symptoms, slow the disease progression and improve the urinary flow. Lesions began to remiss after 2-4 weeks of treatment in all of the patients, the appearance of the involved skin became roughly normal after 20-24 weeks of treatment. The urinary flow returned to normal only in one child and the other 5 children hadn＇t been improved significantly. Conclusion The BXO in boys always presents after urological operation and topical tacrolimus is markedly effective for BXO, and the curative urological surgery is recommended when the disease is complicated with meatal or urethral stenosis.
出处
《实用皮肤病学杂志》
2017年第5期264-266,共3页
Journal of Practical Dermatology
基金
北京市科委"首都临床特色应用研究"专项课题(Z161100000516070)
北京市医院管理局临床医学发展专项(ZYLX201601)
