The Clinical Analysis On 46 Cases Of Children’s Generalized Pustular Psoriasis

Research background and purposeGeneralized pustular psoriasis (GPP), a kind of special psoriasis, is not common. The exact causes of GPP may be the interactions of genetic and environmental factors which are not very clear. The GPP of children is more rare Clinical whose common causative factor is acute psoriasis of guttata, it is induced by the infection, the corticosteroids or the inappropriate treatment of immunosuppressant or the external drugs stimulation, etc. Clinical children with GPP is acute onset mostly. It is shown as skin damage:millet to mung bean size aseptic pustules are widespread, often accompanied by the serious performance with high fever, pain and swelling of the joints, white blood cell elevated and hypoalbuminemia, the dangerous disease is even life-threatening. Previous clinical research literature about the GPP is not uncommon and mostly concentrated on the adult with GPP.The literatures of clinical research are little on the children with GPP, Due to clinical material on children with GPP is rare, some dermatologists master the relevant knowledge of the disease insufficiently.In order to improve the understanding and the level of diagnosis and treatment for children for the clinician on GPP, the study aimed at analysising the diagnosis and treatment of the children with GPP in our dermatological department in recent years, Approaching the subject induced or aggravating factors of GPP in children, clinical manifestation, laboratory examination and treatment, providing reference for clinical diagnosis and treatment.Materials and methodsThe study were collected 46 cases of children patients with GPP from Department of Dermatology in the First Affiliated Hospital of Zhengzhou University and the fourth people’s hospital of shangqiu city between January in 2002 to December in 2012. The children patients with GPP were Less than 12 years old. The typical lesion of skin damage in clinical manifestations, eliminating other aseptic impetigo, clinical diagnosising clearly.The study were used the method of retrospective analysis, including gender of children patients of GPP, age distribution, inducing and aggravating factors, clinical manifestations, family history, laboratory examination and treatment, The data were analysised by T test, analysis of variance in the software of SPSS17.0.Results:1 The distribution of gender:Among 46 cases of children with GPP, male:27, female:19, the proportion of boy and girl:1:0.70, there was no significant difference in gender distribution(P>0.05).2 Age:Among 46 cases of children with GPP, from the minimum age 8 months(0.67 years old) to maximum 11 years old and 9months (11.75 years), average age 6.72 ± 2.45 years, less than 1 year:2 cases (4.34%),1-5 years:13 cases (28.26%), above 5 years old:32 cases (69.57%), the highest esimate.3 Pathogenic factors:19 cases with a history of upper respiratory tract infection before disease,including 11 cases of pharyngeal portion hyperemia,tonsil intumesce,8 cases with cough, runny nose and pulmonary infection,8 cases of improper use of corticosteroids,5 cases with drug induced by inappropriate factors, 14 cases without clear etiology in 46 children patients.4 Family history:11 cases with family history of psoriasis vulgaris and 3 cases with family history of pustular psoriasis.5 Clinical features:There were skin lesions of pustules aseptic with the typical tip to the miliary size in 46 cases, often accompanied by systemic symptoms, including 40 patients with varying degrees of itching, fever in children with different degree in 46 cases, mostly remittent fever or irregular fever, body temperature up to 39-40-C.5 cases with fissured tongue; 7 cases with mucosal damage (red lips, scaling); 1 patients with deck hypertrophy of fingernails or toenais, turbidity, fragmentation, pustule of without nail,2 cases with skin pain.6 Laboratory examination:Most patients’leukocytes, neutrophils increased in routine blood test in several laboratory examinations, some patients’lymphocytes and eosinophils increased, the red blood cells and hemoglobin decreased, hypoproteinemia, alkaline phosphatase increased of liver function.7 Treatment:Individualized treatment should be choosen according to clinical manifestations and laboratory examination, including Antibiotics, compound glycyrrhizin, glucocorticoids, retinoic acid, immune inhibitors, part with antihistamines, traditional chinese medicine.8 Curative effect and prognosis:The prognosis after treatment, most patients were cured or effective.Conclusions:1 The clinical physicians should improve awareness because GPP in children is rare clinically and shown complexly.2 The exact etiology of GPP in children is not very clear, but the predisposing factors are common, it is good way to reduce the GPP in children by avoiding or reducing the induced factors.3 An individualized treatment should be selected for GPP in children whose bases are patient age, psoriasis of clinical manifestation, laboratory examination.