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患者,男性,41岁。主因全身起红疙瘩、脓疱、脱屑、痒2年,皮损复发伴发热于1997年7月31日入院。此前曾经省级医院按脓疱型银屑病治疗皮损减少,但仍反复发作。于入院前2个月皮损复发后开始应用激素,最初量相当于强的松每日34mg,皮损基本控制后逐步减量至每日15mg,维持治疗1个月后,自行停服强的松2天,皮损泛发全身,伴体温升高,波动于38℃～39℃之间而入院。查体:T39.9℃,P120次/分,R30次/分,BP16/9kPa。急性病容,心肺腹无异常。皮科情况:躯干四肢可见泛发分布的黄豆至甲盖大小的红色斑块,表面覆银白色鳞屑,刮之见薄膜现象及点状出血。并有密集的粟粒大小红色丘疹,丘脓疱疹,无渗出及糜烂,皮损间可见正常皮肤。实验室检查:血常规:白红蛋白120g/L,白细胞10.9×10~9/L,中性0.70,淋巴0.30。入院诊断:脓疱型银屑病。
Patient, male, 41 years old. The main reason for the whole body from red knots, pustules, scaling, itch 2 years, recurrence of skin lesions with fever on July 31, 1997 admission. Prior to the provincial hospital pustular psoriasis lesions reduction, but still recurrent. 2 months before admission, the onset of skin lesions relapse after the start of the application of hormones, the initial amount of prednisone equivalent to 34mg daily, the basic control of skin lesions and gradually reduced to 15mg daily maintenance treatment for 1 month, stop their own strong Pine 2 days, generalized lesions, fever, accompanied by body temperature fluctuations between 38 ℃ ~ 39 ℃ and admission. Physical examination: T39.9 ℃, P120 beats / min, R30 beats / min, BP16 / 9kPa. Acute illness, no abnormal heart and lung abdomen. Pico case: the trunk of the limbs can be seen the general distribution of soybeans to the size of a red plate covered with silver, the surface covered with silver scales, scraping see the film phenomenon and punctate bleeding. And dense miliary size red papules, cough pus herpes, no exudation and erosion, the skin can be seen between normal skin. Laboratory tests: blood: white blood protein 120g / L, white blood cells 10.9 × 10 ~ 9 / L, neutral 0.70, lymph 0.30. Admission diagnosis: pustular psoriasis.