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上海某区老年特应性皮炎临床特征分析

Clinical analyses of atopic dermatitis in the senility in Shanghai

  • 摘要:
    目的 探讨老年期特应性皮炎(atopic dermatitis, AD)的临床特征。
    方法 以下列AD诊断标准为依据:(1)病程超过6个月的对称性湿疹;(2)特应性个人史和/或家族史;(3)血清总IgE升高和/或外周血嗜酸性粒细胞(EOS)升高和/或过敏原特异性IgE阳性。第1条加第2条或第3条即可诊断。收集2019年—2020年我院门诊204例AD患者临床资料并分析临床特征。
    结果 患者平均年龄(70.51±7.58)岁,年龄60~96岁。其中男性112例,年龄(70.04±6.85)岁;女性92例,年龄(71.09±8.34)岁。首次发病年龄多在40~70岁,大多数患者皮损主要表现为湿疹样皮炎,伴瘙痒明显,主要发病部位在躯干和下肢。多数老年AD患者同时罹患1种或多种系统性疾病。EOS检测阳性率为3.92%(8例);总IgE阳性检测阳性率为24.02%(49例)。血清特异性IgE(sIgE)检测结果显示,吸入组以狗毛皮屑(25.00%),杨柳、梧桐(25.49%)阳性率较高;食入组以腰果(8.82%)、虾(9.31%)、蟹(8.33%)和鸡蛋白(8.33%)的阳性率较高。
    结论 老年AD患者多瘙痒明显,主要发病部位在躯干和下肢,多伴随系统性疾病,多种食入性和吸入性过敏原检测阳性。

     

    Abstract:
    Objective The aim of this study was to analyze the characteristics of atopic dermatitis (AD) in the senility.
    Methods Based on Zhang Jianzhong's diagnostic criteria for AD (three features as the criteria for adult/adolescent AD: (1)eczema for more than 6 months; (2) personal and/or family history of atopic diseases; (3) elevated total serum IgE level and/or positive allergen-specific IgE and/or eosinophilia; (1) + (2) or (1) + (3) can be diagnosis basis), subjects were comprised of 204 patients investigated for clinical features, EOS, serum immunoglobulin IgE levels and skin manifestations.
    Results Mean age was (70.51±7.58) years (range: 60-96). Most patients had eczematous dermatitis, obvious pruritus and manifested predominantly in the trunk and lower limbs. Most elderly patients with specific dermatitis suffered from one or more systemic diseases at the same time. Eight patients(3.92%) showed positive for EOS, and forty-nine patients (24.02%) showed positive results for total IgE anti-bodies.The most common allergens for specific IgE in inhalation allergens group were dog hairs and scales (25%) willow and Chinese parasol (25.49%). The food allergens were mainly cashew (8.82%), shrimp (9.31%), crab (8.33%) and egg white (8.33%).
    Conclusions Elderly patients with AD have obvious pruritus, mainly in the trunk and lower limbs, accompanied by a variety of systemic diseases. A variety of ingestive and inhalation allergens detected serologically are positive.

     

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