【摘要】 目的:探讨反常性痤疮(acne inversa,AI)的临床及组织病理特征,总结不典型患者的诊断方法以及治疗方案。方法:收集2009年—2014年该科就诊的13例AI患者的临床及组织病理资料,归纳出不典型患者的诊断方法,评估异维A酸治疗该病的疗效。结果:临床主要表现为腋窝、臀部和头皮的炎性丘疹、结节及脓肿,伴瘘管窦道及挛缩瘢痕形成等多种皮损同时存在,并见具有诊断价值的双头粉刺和多头囊肿。8例患者(61.5%)有严重痤疮家族史。9例患者(69.3%)临床表现不典型的患者需借助组织病理检查明确诊断。典型组织病理表现为毛囊及毛囊周围炎,破坏或残留的毛囊及皮脂腺组织是诊断本病的重要线索。采用异维A酸联合米诺环素治疗,痊愈9例(72.7%),好转2例(18.2%),1例复发(9.1%)。结论:不典型AI患者需结合临床特征、组织病理及遗传家族史,排除其他疾病等方可诊断。异维A酸联合米诺环素治疗对大部分患者有效。更多还原

【Abstract】 Objective: To study the clinical and pathologic characteristics of acne inversa(AI), and the diagnosis and the treatment of atypical AI. Methods: Clinical data were analyzed in 13 cases of AI in our hospital from 2009 to 2014. The diagnosis method of atypical AI and therapeutic efficacy of isotretinoin were further analyzed. Results: The main clinical manifestations of AI included coexistence of inflamed papules, nodules, sinus tracts and abscesses, or atrophic scar on the armpit, buttocks and scalp. The presence of double headed acne and multiple cysts was most suggestive for the diagnosis of AI. Eight patients(61.5%) had a family history of severe acne. 9 cases(69.2%) required histopathology to confirm the diagnosis of atypical AI. Folliculitis and perifolliculitis were the typical changes in histopathology. Rupture of the pilosebaceous unit was a key indicator of atypical AI. Following treatment with oral isotretinoin plus minocycline, nine cases(72.7%) were cured, two(18.2%)improved, and one relapsed(9.1%). Conclusion: The diagnosis of AI should be based on clinical and pathologic characteristics,family history and exclusion of other diseases. Combination of isotretinoin and minocycline is effective for most patients.更多还原