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首页> 外文期刊>Medical principles and practice: international journal of the Kuwait University, Health Science Centre >Resistant Palmoplantar Lesions in Patients of Psoriasis: Evaluation of the Causes and Comparison of the Frequency of Delayed-Type Hypersensitivity in Patients without Palm and Sole Lesions
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Resistant Palmoplantar Lesions in Patients of Psoriasis: Evaluation of the Causes and Comparison of the Frequency of Delayed-Type Hypersensitivity in Patients without Palm and Sole Lesions

机译：银屑病患者抵抗性掌足部病变：无掌部和足底病变的患者迟发性超敏反应发生频率的原因分析和比较

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Objective: To examine the reasons for resistance to treatment in cases of palmoplantar psoriasis, and also to compare the frequency of delayed-type hypersensitivity to common sensitizers with those cases of psoriasis without palmoplantar involvement. Subjects and Methods: One hundred and three patients with resistant palmoplantar psoriasis were examined for a possible drug reaction, fungal infection or contact allergy. Patch testing was done for another 100 patients with psoriasis vulgaris without palm and sole involvement. χ2, Fischer's exact test, Mann-Whitney U test and logistical regression analysis were done using SPSS 15.0. Results: Of the 103 patients with resistant palmoplantar lesions, 26 (25.24%) had a positive patch test to at least one of the tested allergens, 6 (5.8%) had psoriasiform spongiotic dermatitis on biopsy, 5 (4.8%) reported exacerbation after starting biologic therapy and 3 (2.9%) were potassium hydroxide positive in the sole lesions. In comparison, of the 100 patients with no palm or sole lesions, 11 (11%) had a positive patch test to at least one of the allergens. There was a direct relationship between the increase in the prevalence of dermatitis and the duration of psoriasis. There was no correlation between the clinical type of psoriasis and patch-test positivity. Conclusion: Secondary fungal infection, allergic contact dermatitis to topical agents or common allergens, or at times an unusual reaction to the antipsoriatic therapeutic agents sometimes led to treatment failure in patients with psoriasis vulgaris with palmoplantar lesions. Also, psoriasis patients with palm and sole lesions tended to have higher rates of contact hypersensitivity than patients without lesions on their palms and soles.
机译：目的：探讨掌plant型牛皮癣患者对治疗的抵抗力的原因，并比较对普通敏化剂的迟发型超敏反应发生率和不伴掌plant型牛皮癣的病例。研究对象和方法：检查了103例掌resistant性银屑病耐药患者的可能的药物反应，真菌感染或接触性过敏。对另外100名寻常型牛皮癣患者进行了补丁测试，没有手掌和足底受累。使用SPSS 15.0进行χ 2 ，Fischer精确检验，Mann-Whitney U检验和逻辑回归分析。结果：在103例掌resistant抵抗性皮损患者中，有26例（25.24％）对至少一种过敏原的贴片试验呈阳性，活检时有6例（5.8％）患有牛皮癣型海绵状皮炎，5例（4.8％）术后加重开始进行生物治疗时，仅有3个（2.9％）的氢氧化钾在唯一的病变中呈阳性。相比之下，在100名没有手掌或足底病变的患者中，有11名（11％）对至少一种过敏原的贴片试验呈阳性。皮炎患病率的增加与牛皮癣持续时间之间存在直接关系。牛皮癣的临床类型与斑贴试验阳性之间没有相关性。结论：继发性真菌感染，对局部药物或常见过敏原的过敏性接触性皮炎，或有时对银屑病治疗药物的异常反应有时会导致寻常型牛皮癣伴掌plant病变的患者治疗失败。而且，具有手掌和足底病变的牛皮癣患者倾向于比没有其手掌和脚底病变的患者具有更高的接触超敏反应率。

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