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Netherton综合征1例

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患者女,54岁,全身红斑鳞屑、毛发异常出生即有.皮肤科情况:躯干四肢呈红皮病样外观、多环状、匍行性红斑,特异性"双边"鳞屑,干燥、纤细的鱼鳞病样鳞屑,毛发异常表现为:毛发短、脆、无光泽,眉毛、睫毛稀疏.皮损组织病理示:角化过度,角化不全,表皮不规则增厚,细胞间内水肿,真皮内胶原断裂、卷曲、缺失,红细胞外渗,少量炎细胞浸润,部分皮下脂肪变性.基因测序:行全外显子基因检查可检测到SPINK5基因存在一个纯合错义变异c.2423C>T:p.T808I.根据皮肤损害及基因检查,诊断考虑Netherton综合征.治疗上给予丙酸氟替卡松软膏、维A酸乳膏及维生素E乳,比例1∶1混合外用.鉴别诊断:本病需与特应性皮炎、高IgE综合征、红皮病及omenn综合征等鉴别.
Netherton Syndrome:A Case Report
A 54-year-old female was born with erythema,scales and abnormal hair.Dermatology examination showed erythroderma-like appearance in trunk and limbs,multi-ring and creeping erythema,specific"bilateral"scales,dry,slender ichthyosis-like scales;Hair abnormalities were short,brittle and dull;Eyebrows and eyelashes were sparse.Pathological examination showed:hyperkeratosis,dyskeratosis,irregular thickening of epidermis,intercellular edema,fracture,curl and loss of collagen in dermis,extravasation of red blood cells,infiltration of a small amount of inflammatory cells,and partial subcutaneous steatosis.Gene sequencing:SPINK5 gene had a homozygous missense mutation C.2423c>T:P.T808i detected in the whole exon gene examination.According to the skin damage and genetic examination,Netherton syndrome was diagnosed.Fluticasone propionate ointment,tretinoin cream and vitamin E emulsion were given for external use in a ratio of 1∶1.This disease should be differentiated from atopic dermatitis,hyperIgE syndrome,erythroderma and omenn syndrome.

Netherton syndromeClinical featureSPINK5 gene

乌日嘎、韩建文

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内蒙古医科大学附属医院皮肤科,内蒙古呼和浩特 010050

Netherton综合征 临床表现 SPINK5基因

内蒙古自治区自然科学基金项目内蒙古医科大学面上项目

2020MS08112YKD2021MS039

2024

皮肤科学通报
西安交通大学

皮肤科学通报

CSTPCD
影响因子:0.273
ISSN:1001-8077
年,卷(期):2024.41(4)
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