摘要
目的探讨老年特应性皮炎(atopic dermatitis,AD)的临床表现和特征,提高对老年AD的认识,为老年AD诊治提供参考。方法根据Hanifin-Rajka标准,收集2018年1月-2020年12月在复旦大学附属华东医院皮肤科门诊就诊且诊断为老年AD的118例患者,对其临床特征、实验室检查和伴发疾病进行统计分析。结果本组118例中,男女比例为2.37:1,平均年龄为(72.3±4.7)岁。发病模式主要为老年发病,共78例(66.1%)。临床分型主要为外源型,共88例(74.6%)。实验室检查显示,患者平均嗜酸性细胞计数(357.9±268.3)mm~3,平均嗜酸细胞百分比(16.5±9.2)%。平均血清总IgE(371.8±302.6)IU/mL,特异性IgE阳性共有41例(34.7%),主要致敏原为屋尘螨。老年AD皮肤特征性表现为躯干和四肢伸侧的湿疹样损害,表现为干燥性红斑和苔藓样改变。皮损多分布在四肢伸侧,屈侧较少见,肘窝和腘窝较少出现湿疹样皮损,呈皮损"反转"征象。患者的伴发基础疾病依次为高血压90例(76.3%)、心脏疾病42例(35.6%)、恶性肿瘤3(2.5%)。结论老年AD作为一个新的AD亚型,具有一些特殊的临床特征和表现,需要充分认识老年AD的临床特征。
Objective To investigate the clinical manifestations and characteristics of atopic dermatitis(AD)in the elderly,and to provide reference for the diagnosis and treatment of AD in the elderly.Methods According to Hanifin-Rajka criteria,118 elderly patients diagnosed with AD who visited the Department of Dermatology of Huadong Hospital from January2018 to December 2020 were collected,and their clinical characteristics,laboratory tests and concomitant diseases were statistically analyzed.Results In 118 cases,the ratio of male to female was 2.37:1,and the average age was(72.31±7)years old.The main onset pattern was geriatric onset,including 78 cases(66.1%).The main clinical type was the extrinsic type,including88 cases(74.6%).Laboratory examination showed that the average eosinophil count of the patients was(357.9±268.3)mm~3 and the average eosinophil percentage was(16.5±9.2)%.The average total serum IgE was(371.8±302.6)IU/mL,and 41 patients(34.7%)were positive for specific IgE and the main allergen was house dust mite.The skin was characterized by eczemalike lesions on the trunk and extensible sides of the limbs,manifested as dry erythema and lichen-like changes.The skin lesions were mostly distributed on the extensible side of the limbs,and rare on the flexed side of the limbs.There were few eczemalike lesions in the cubital fossa and popliteal fossa,showing signs of"reverse"skin lesions.The most concomitant diseases were hypertension(90 cases,76.3%),heart disease(42 cases,35.6%)and malignant tumor(3 cases,2.5%).Conclusion As a new subtype of AD,AD in the elderly has some special clinical characteristics and manifestations.It is necessary to fully understand the clinical characteristics of AD in the elderly.
作者
黄建华
吕婷
吴闽枫
吴淑恬
施靖娟
王宏伟
Huang Jianhua;Lv Ting;Wu Minfeng;Wu Shutian;Shi Jingjuan;Wang Hongwei(Department of Dermatology,Huadong Hospital/Department of Geriatric Dermatology,Shanghai Institute of Geriatrics,Fudan University,Shanghai,200040,P.R.China)
出处
《老年医学与保健》
CAS
2021年第3期465-469,488,共6页
Geriatrics & Health Care
关键词
老年
特应性皮炎
临床特征
皮肤表现
elderly
atopic dermatitis
clinical characteristics
skin manifestations
