维甲酸引起一例肝病患者皮肤变脆

来源 :国外医学.皮肤病学分册 | 被引量 : 0次 | 上传用户:cx8105
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一例52岁男性,在病理组织学上证实患有洒精中毒性肝硬化的严重红皮症银屑病患者,于1979年6月开始应用维甲酸治疗,25rag每日3次。在其后的两年半,患者继续大量饮酒,但其肝功能稳定。继续服用维甲酸,能很好地控制其银屑病。在1982年4月,出现环绕下腿的溃疡。腿部溃疡卧床休息、治疗。维甲酸仍25rag一日3次。4周后,其皮肤渐渐变得光滑发亮,脱发,指甲脱落,受压部化如臀部、脊柱发生表在糜烂。以后唇周、鼻翼和眼部发生出血性结廊。此时出现肝性脑病,并伴有肾功能衰竭前症状。一月后停用维甲酸。由于病人过去火量饮酒,而发生渐进性精神混乱,并发现有甲状腺功能低下,9个月后死于支气管肺炎。从腿上取完整无疱的皮肤活检。显示表皮片状坏死,在其他病变较著的部位,则见在表皮内和表皮下有含大量纤维蛋 A 52-year-old man histologically characterized as severe psoriasis with splenomegaly toxic cirrhosis was treated with tretinoin beginning in June 1979 and thrice a day for 25rag. During the next two and a half years, patients continued to drink heavily, but their liver function was stable. Continue to take retinoic acid, can control its psoriasis. In April 1982, an ulcer around the lower leg appeared. Leg ulcer bed rest, treatment. Retinoic acid is still 25rag three times a day. After 4 weeks, the skin gradually becomes smooth and shiny, hair loss, nails off, pressure of the Ministry of the buttocks, spine table in erosion. After lip weeks, nose and eye hemorrhagic corridor. Hepatic encephalopathy occurs at this time, and accompanied by symptoms of renal failure. Retinoic acid was discontinued after January. Due to the patient’s excessive consumption of alcohol during the past, progressive mental disorders occurred and hypothyroidism was found and died of bronchopneumonia after 9 months. Take a complete blister-free biopsy from your leg. Showed epidermal plate necrosis, in other parts of the lesion, then see in the epidermis and epidermis have a lot of fiber eggs
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