慢性湿疹患者临床特征的研究

L. V. Fomina, A. Dashchuk, E. Dobrzhanska
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摘要

目的探讨96例18 ~ 78岁慢性湿疹(CE)患者的临床特点。材料和方法。这项研究是在哈尔科夫市临床皮肤性病诊所第5号进行的。所有患者均给予参与研究的书面知情同意。其中年龄在31 ~ 50岁之间的占66.7%。6.3%的被调查者皮肤病病程为6个月至1年,33.3%为1年至5年,42.7%为5年至10年,17.7%为10年以上。最常见的恶化原因是神经精神创伤和压力(51.1%),15.6%(内脏疾病和急性呼吸系统疾病),13.5%(接触化学品)。所有患者均有皮肤病复发。最常见的是,调查患者抱怨中度瘙痒(51%)和严重的睡眠障碍(66.7%)。21.9%的患者有中度白细胞增多和ESR加速,5.1%的患者有嗜酸性粒细胞增多。结果和讨论。对96例18 ~ 78岁慢性湿疹患者进行观察。慢性湿疹的诊断是根据患者的记忆资料、患者对不同程度皮肤瘙痒的主诉、患者的客观检查以及1年以上的皮肤病复发情况。5 ~ 10岁的患者患皮肤病的人数最多。观察患者慢性湿疹复发。缓解期为(4.9±0.2)个月。加重时间为(6.1±0.2)周。慢性湿疹的严重程度采用评分系统,平均严重程度为(2.63±0.08)分。根据皮肤病变的程度,皮肤病的形式是有限的和广泛的。患者主诉皮肤瘙痒强度不等:多为中等强度、周期性瘙痒;痛苦的,执着的,有一种无法克服的需要去挠;短期;没有瘙痒。此外,患者注意到睡眠障碍,表现为入睡困难,夜间突然醒来,早晨醒来后缺乏休息的感觉。39例患者有不良生活习惯(吸烟、酗酒)。Сlinical血液分析显示中度白细胞增多,ESR加速,嗜酸性粒细胞增多,继发感染的迹象。结论。患者平均年龄31 ~ 50岁。所有患者均有复发性皮肤病。其严重程度平均为(2.63±0.08)分。最常见的是,患者抱怨中度瘙痒(51%)和严重睡眠障碍(66.7%)。21.9%的患者有中度白细胞增多和ESR加速,5.1%的患者有嗜酸性粒细胞增多。
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Study of clinical features of patients with chronic eczema
Objective — s to study the clinical features of chronic eczema (CE) in 96 patients aged 18 to 78 years. Materials and methods. The study was carried out in the city clinical dermatovenerological dispensary No. 5 in Kharkov. All patients gave written informed consent to participate in the study.The majority of them (66.7 %) were between 31 and 50 years old. The duration of dermatosis in 6.3 % of the surveyed persons ranged from 6 months to 1 year, in 33.3 % — from 1 year to 5 years, in 42.7 % — from 5 to 10 years, in 17.7 % — over 10 years. The most frequent causes of exacerbation in 51.1 % were neuropsychiatric trauma and stress, in 15.6 % — dise­ases of internal organs and acute respiratory diseases, in 13.5 % — contact with chemicals. In all patients, dermatosis was recurrent. Most often, the surveyed patients complained of moderate intensity itching (51 %) and severe sleep disturbances (66.7 %). Moderate leukocytosis and accelerated ESR were found in 21.9 % of patients, eosinophilia — in 5.1 %. Results and discussion. 96 patients with chronic eczema aged 18 to 78 years were under observation. The diagnosis of chronic eczema was based on anamnestic data, patients’ complaints of itchy skin of varying intensity, objective examination of the patient, as well as recurrences of dermatosis for more than 1 year. The largest number of patients had dermatosis from 5 to 10 years. Chronic eczema in the observed patients was recurrent. The duration of remission was (4.9 ± 0.2) months. The duration of exacerbation was (6.1 ± 0.2) weeks. To characterize the severity of chronic eczema, a scoring system was used, according to which the average severity was (2.63 ± 0.08) points.According to the degree of skin lesions, the forms of dermatosis were limited and widespread. Patients complained of skin itching of varying intensity: more often itching of moderate intensity, periodic; painful, persistent, with an insurmountable need to scratch; short-term; no itching.Also, patients noted sleep disturbance in the form of difficulty falling asleep, sudden awakening at night and lack of a feeling of rest after waking up in the morning. 39 patients had bad habits (smoking, alcohol abuse).Сlinical analysis of blood revealed moderate leukocytosis, accelerated ESR, eosinophilia, signs of secondary infection. Conclusions. The average age of the patients ranged from 31 to 50 years. All examined patients had recurrent dermatosis. The average degree of its severity was (2.63 ± 0.08) points. Most often, patients complained of moderate intensity itching (51 %) and severe sleep disturbances (66.7 %). In 21.9 % of the examined patients moderate leukocytosis and accelerated ESR were revealed, in 5.1 % — eosinophilia.
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