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由1例亚急性皮肤型红斑狼疮引发对不完全型红斑狼疮的思考

Thinking about incomplete lupus erythematosus caused by subacute cutaneous lupus erythematosus in 1 case
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摘要 通过对1例亚急性皮肤型红斑狼疮(SCLE)复发病例的预后指导,产生对目前国内现有红斑狼疮以皮肤组织病理特异性皮损为依据分类诊断的质疑,由于皮肤科特有的诊断特点,对有严重器官受累进展可能性的患者不利。因此,作者引用不完全型红斑狼疮(ILE)这一术语,尽管国外对不完全型红斑狼疮早有报道,但国内使用不完全型红斑狼疮的报道罕见,国外在对不完全型红斑狼疮的研究中纳入的标准差异较大,近几年对抗核抗体(ANA)≥1∶80阳性标记不完全型红斑狼疮是否能提高不完全型红斑狼疮诊断的研究较多,作者分析了国内使用不完全型红斑狼疮较少的原因,并希望国内临床医生尤其是皮肤科医生应用不完全型红斑狼疮一词打破这种局限,不是直接从国外的不完全型红斑狼疮相关研究数据直接套用,而是收集不完全型红斑狼疮患者的临床数据、做好跟踪随访等工作,以便更好地为临床试验和制定更敏感的不完全型红斑狼疮标准的研究提供支持,分析目前的临床治疗干预措施对不同的不完全型红斑狼疮风险层面管理的合理性,提升患者的心理弹性,从而改善患者的预后和生活质量。 By guiding the prognosis of a recurrent case of subacute cutaneous lupus erythematosus(SCLE),this paper questions the current classification of lupus erythematosus on the basis of skin histopathological specific lesions in China.Because of the unique diagnostic characteristics of dermatology,it is disadvantageous to the patients with the possibility of serious organ involvement.Therefore,the author quotes the term incomplete lupus erythematosus(ILE).Although there are early reports on ILE abroad,the report on the use of ILE in China is rare,and the inclusion criteria for incomplete lupus erythematosus are quite different in foreign countries.In recent years,there are many studies on whether the positive marker ILE with antinuclear antibody(ANA)≥1∶80 can improve the diagnosis of incomplete lupus erythematosus.The author analyzes the reasons for the less use of incomplete lupus erythematosus in China.It is hoped that domestic clinicians,especially dermatologists,will use the word incomplete lupus erythematosus to break this limitation,not directly from foreign incomplete lupus erythematosus-related research data,but to collect clinical data of incomplete lupus erythematosus patients and do a good job of follow-up,so as to provide better support for clinical trials and the formulation of more sensitive standards of incomplete lupus erythematosus,and to analyze the rationality of current clinical treatment interventions for the management of different ILE risk levels.
作者 崔文悦 李海波 CUI Wen-yue;LI Hai-bo(Department of Dermatology,Jiamusi University,First Affiliated Hospital of Jiamusi University,Jiamusi 154002,China)
出处 《中国实用医药》 2020年第28期161-163,共3页 China Practical Medicine
关键词 亚急性皮肤型红斑狼疮 不完全型红斑狼疮 诊断标准 Subacute cutaneous lupus erythematosus Incomplete lupus erythematosus Diagnostic criteria
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