Erythroderma with complicated etiology is one of the severe skin diseases and has high mortality, of which the incidence was 0.5‰–1.5‰ in skin diseases. Erythrodermic psoriasis（EP） is the commonest type of erythr...Erythroderma with complicated etiology is one of the severe skin diseases and has high mortality, of which the incidence was 0.5‰–1.5‰ in skin diseases. Erythrodermic psoriasis（EP） is the commonest type of erythroderma. In addition, there are drug-induced erythroderma, erythroderma secondary to preexisting dermatoses, malignancy-related erythroderma, and idiopathic erythroderma of unknown etiology. Erythroderma of different etiologies has various clinical manifestations, resulting in relevant curative effects and outcomes. In this article, we retrospectively investigated 205 erythroderma patients about clinical symptoms, auxiliary examination and treatments, and evaluated the efficacy and prognosis. There were 84 cases of EP among 205 patients, 10 cases of erythroderma caused by specific drugs, 77 cases of erythroderma secondary to preexisting dermatoses（excluding psoriasis）, 7 cases of erythroderma patients suffering from malignancy and 27 cases with unknown causes. We concluded that the etiology of male patients in different age groups had significant difference. The incidence of EP was the highest among all types. The EP was commonly accompanied with hypoproteinemia, and changed into psoriasis vulgaris after treatment. Drug-induced erythroderma was commonly accompanied with fever, and mostly cured by systematic steroid therapy. For erythroderma secondary to preexisting dermatoses, the original dermatoses must be actively treated to achieve a satisfying prognosis. Erythroderma with malignancy or unknown causes had long-term duration, poor response to the treatment, and high potential to relapse. Therefore, clarifying the etiology, providing an appropiate and individual regimen, and regular follow-up are crucial for the successful treatment of erythroderma with unknown causes.展开更多
Coronavirus disease 2019(COVID-19),which is caused by severe acute respiratory syndrome coronavirus-2(SARS-CoV-2),has spread around the world.However,approaches to distinguish COVID-19 from pneumonia caused by other p...Coronavirus disease 2019(COVID-19),which is caused by severe acute respiratory syndrome coronavirus-2(SARS-CoV-2),has spread around the world.However,approaches to distinguish COVID-19 from pneumonia caused by other pathogens have not yet been reported.We retrospectively analyzed the clinical data of 97 children with probable COVID-19.A total of 13(13.4%)patients were confirmed positive for SARS-CoV-2 infection by nucleic acid RT-PCR testing,and 41(42.3%)patients were found to be infected with other pathogens.Notably,no pathogen was detected in 43(44.3%)patients.Among all patients,25(25.8%)had familial cluster exposure history,and 52(53.6%)had one or more coexisting conditions.Fifteen(15.5%)patients were admitted or transferred to the PICU.In the 11 confirmed COVID-19 cases,5(45.5%)and 7(63.6%)were positive for IgM and IgG against SARS-CoV-2,respectively.In 22 patients with suspected COVID-19,1(4.5%)was positive for IgG but negative for IgM.The most frequently detected pathogen was Mycoplasma pneumonia(29,29.9%).One patient with confirmed COVID-19 died.Our results strongly indicated that the detection of asymptomatic COVID-19 or coexisting conditions must be strengthened in pediatric patients.These cases may be difficult to diagnose as COVID-19 unless etiologic analysis is conducted.A serologic test can be a useful adjunctive diagnostic tool in cases where SARS-CoV-2 infection is highly suspected but the nucleic acid test is negative.展开更多
基金supported by the National Natural Science Foundation of China(No.81673057 and No.81502735)
文摘Erythroderma with complicated etiology is one of the severe skin diseases and has high mortality, of which the incidence was 0.5‰–1.5‰ in skin diseases. Erythrodermic psoriasis（EP） is the commonest type of erythroderma. In addition, there are drug-induced erythroderma, erythroderma secondary to preexisting dermatoses, malignancy-related erythroderma, and idiopathic erythroderma of unknown etiology. Erythroderma of different etiologies has various clinical manifestations, resulting in relevant curative effects and outcomes. In this article, we retrospectively investigated 205 erythroderma patients about clinical symptoms, auxiliary examination and treatments, and evaluated the efficacy and prognosis. There were 84 cases of EP among 205 patients, 10 cases of erythroderma caused by specific drugs, 77 cases of erythroderma secondary to preexisting dermatoses（excluding psoriasis）, 7 cases of erythroderma patients suffering from malignancy and 27 cases with unknown causes. We concluded that the etiology of male patients in different age groups had significant difference. The incidence of EP was the highest among all types. The EP was commonly accompanied with hypoproteinemia, and changed into psoriasis vulgaris after treatment. Drug-induced erythroderma was commonly accompanied with fever, and mostly cured by systematic steroid therapy. For erythroderma secondary to preexisting dermatoses, the original dermatoses must be actively treated to achieve a satisfying prognosis. Erythroderma with malignancy or unknown causes had long-term duration, poor response to the treatment, and high potential to relapse. Therefore, clarifying the etiology, providing an appropiate and individual regimen, and regular follow-up are crucial for the successful treatment of erythroderma with unknown causes.
基金This study was supported by the National Natural Science Foundation of China(No.81741099).
文摘Coronavirus disease 2019(COVID-19),which is caused by severe acute respiratory syndrome coronavirus-2(SARS-CoV-2),has spread around the world.However,approaches to distinguish COVID-19 from pneumonia caused by other pathogens have not yet been reported.We retrospectively analyzed the clinical data of 97 children with probable COVID-19.A total of 13(13.4%)patients were confirmed positive for SARS-CoV-2 infection by nucleic acid RT-PCR testing,and 41(42.3%)patients were found to be infected with other pathogens.Notably,no pathogen was detected in 43(44.3%)patients.Among all patients,25(25.8%)had familial cluster exposure history,and 52(53.6%)had one or more coexisting conditions.Fifteen(15.5%)patients were admitted or transferred to the PICU.In the 11 confirmed COVID-19 cases,5(45.5%)and 7(63.6%)were positive for IgM and IgG against SARS-CoV-2,respectively.In 22 patients with suspected COVID-19,1(4.5%)was positive for IgG but negative for IgM.The most frequently detected pathogen was Mycoplasma pneumonia(29,29.9%).One patient with confirmed COVID-19 died.Our results strongly indicated that the detection of asymptomatic COVID-19 or coexisting conditions must be strengthened in pediatric patients.These cases may be difficult to diagnose as COVID-19 unless etiologic analysis is conducted.A serologic test can be a useful adjunctive diagnostic tool in cases where SARS-CoV-2 infection is highly suspected but the nucleic acid test is negative.
