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目的了解三氯乙烯(TCE)药疹样皮炎合并银屑病的发病情况。方法对1例TCE药疹样皮炎合并银屑病的临床资料进行综合分析。结果患者在五金厂接触TCE 28 d后,出现畏寒、发热,接着4 d后胸前区出现红色小丘疹,继而进展至全身,伴颜面、指、趾水肿。其接触TCE浓度超标2.79倍。入院时查患者全身皮肤布满红色斑丘疹,大多融合成片。经糖皮质激素及护肝药等治疗142 d后,TCE皮炎明显好转,停用激素。18 d后,躯干及四肢出现数个约1 cm×1 cm大小的点滴状红色斑丘疹,有层层的银白色鳞屑、薄膜现象及点状出血的临床表现,行背部皮疹皮肤活检,病理检查结果证实为银屑病(寻常型)。结论 TCE药疹样皮炎和精神压力可能作为诱发因素,激发体内免疫紊乱,导致银屑病的发生。
Objective To understand the incidence of trichlorethylene (TCE) drug-like dermatitis with psoriasis. Methods A case of TCE drug-like dermatitis with psoriasis clinical data were analyzed. Results The patient experienced chills and fever after exposure to TCE for 28 days. Then, a small red papules appeared in the chest area after 4 days and then progressed to the whole body accompanied by facial, finger and toe edema. Its exposure to TCE exceeded 2.79 times the concentration. Patient admitted to the body covered with red rash, most of the integration into pieces. After corticosteroids and hepatoprotective treatment of 142 d, TCE dermatitis significantly improved, disable the hormone. After 18 days, a few drops of red rash with a size of about 1 cm × 1 cm appeared on the trunk and extremities, with silvery white scales, the phenomenon of the film and the clinical manifestations of punctate bleeding, skin rash of the back rash and pathological examination The results confirmed as psoriasis (common type). Conclusion TCE drug-induced dermatitis and mental stress may be used as trigger factors to stimulate immune disorders in vivo, leading to the occurrence of psoriasis.