儿童急性泛发性发疹性脓疱病的临床分析

Clinical analysis of childhood acute generalized exanthematous pustulosis

摘要:

目的：了解儿童急性泛发性发疹性脓疱病的发病原因、临床特点及治疗方法。方法：回顾性分析1990年2月至2008年2月该科收治的20例儿童急性泛发性发疹性脓疱病的临床资料。结果：18例患儿发病前有明确的用药史，20例患儿均有发热、全身性红斑、小脓疱。组织病理学检查示表皮内或角层下脓疱形成和真皮浅层水肿。去除可能的发病因素并给予糖皮质激素等治疗后所有患儿均痊愈。结论： 儿童急性泛发性发疹性脓疱病是一种较少见的疾病，多由药物引起，发热和泛发小脓疱是该病的特点，去除诱发因素和及时应用糖皮质激素是治疗的关键。

Abstract:

ObjectiveTo describe the etiology, clinical features and treatment of childhood acute generalized exanthematous pustulosis (AGEP).MethodsClinical data from 20 cases of childhood acute generalized exanthematous pustulosis from 1990 to 2008 were retrospectively reviewed.ResultsEighteen cases had a history of medication, including the use of penicillin (n=6), cephalosporins (n=3)，sulphonamides (n=2), algopyrin (n=2), vaccines (n=2 ) and anti-cold drugs (n=3). Fever and generalized erythematous pustules were observed in all 20 cases. Histopathologic examination revealed spongiform superficial pustules and papillary edema. The patients were asked to stop taking suspected sensitizing drugs and received glucocoticoid treatment (1-2 mg/kg daily). After 3-5 days of the treatment, symptoms were improved and the dosage of glucocoticoid was gradually reduced. All patients were healed within 20 days after treatment. ConclusionsThe cause of AGEP is mainly attributed to the use of antibiotics, sulphonamides, antipyretic analgesics and vaccines in children. AGEP is characterized by fever and widespread pustular eruption of the skin. Removal of sensitizing factors and glucocorticoid administration is important in the treatment of AGEP in children