中国麻风皮肤病杂志 ›› 2026, Vol. 42 ›› Issue (7): 509-514.doi: 10.12144/zgmfskin202607509

• 论著 • 上一篇    下一篇

66例毛发红糠疹患者临床特征及治疗回顾性分析

佘浠宁1,2,3,李阳1,关则璞1,蔡丽婷1,佘昕妍1,黄丽霞1,王晓华1,2   

  1. 1南方医科大学皮肤病医院，广东广州，510091；2南方医科大学第一临床医学院，广东广州，510091；3广州市第一人民医院，广东广州，510180
  • 出版日期:2026-07-15 发布日期:2026-06-29

Retrospective analysis of clinical characteristics and treatment in 66 patients with pityriasis rubra pilaris

SHE Xining1,2,3, LI Yang1, GUAN Zepu1, CAI Liting1, SHE Xinyan1, HUANG Lixia1, WANG Xiaohua1,2   

  1. 1 Dermatology Hospital of Southern Medical University, Guangzhou 510091, China; 2 The First School of Clinical Medicine, Southern Medical University, Guangzhou 510091, China; 3 Guangzhou First People's Hospital, Guangzhou 510180, China
  • Online:2026-07-15 Published:2026-06-29

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摘要： 目的：明确毛发红糠疹（pityriasis rubra pilaris,PRP）患者的临床特征及治疗现状，以期为该病诊疗提供依据。方法：回顾性分析2011年1月至2024年10月南方医科大学皮肤病医院确诊的66例PRP患者的病历资料，分析其人口学特征、临床及病理学特点、治疗方案及疗效。疗效基于医生临床评估分为完全缓解、部分缓解和无效。结果：66例患者中男性占比59%，女性占比41%；发病年龄分层分析发现第一个高峰出现在1~10岁，第二个高峰出现在30~40岁；临床表现为鳞屑性红斑87.9%，毛囊性丘疹37.9%，掌跖角化过度28.8%；典型组织病理学特征毛囊角栓检出率11.6%，棋盘模式检出率16.3%；23例接受皮肤镜检查的患者中，82.6%观察到特征性表现；治疗结果显示，阿维A的总有效率为43.8%，甲氨蝶呤的总有效率33.3%，环孢素总有效率25%；乌司奴单抗总有效率达81.8%。结论：PRP男性多发，发病年龄呈双峰分布；临床表现以鳞屑性红斑为主；典型的病理特征性改变检出率低；皮肤镜是无创辅助诊断 PRP 的有效工具；传统治疗中，阿维A的总有效率优于其他传统治疗方案；对于难治性PRP乌司奴单抗疗效显著。

关键词: 毛发红糠疹, 回顾性研究, IL-12/23抑制剂, 乌司奴单抗

Abstract: Objective: To clarify the clinical characteristics and current treatment status of pityriasis rubra pilaris (PRP) and to provide evidence for the diagnosis and treatment of this disease. Methods: A retrospective analysis was conducted on the medical records of 66 patients diagnosed with pityriasis rubra pilaris (PRP) at the Dermatology Hospital of Southern Medical University from January 2011 to October 2024. Demographic characteristics, clinical and pathological features, treatment regimens, and therapeutic efficacy were analyzed. Treatment efficacy was classified into complete remission, partial remission, and non-response based on the physician's clinical assessment. Results: Among the 66 patients, 59% were male and 41% were famale. Age-stratified analysis of disease onset showed a first peak at 1-10 years of age and a second peak at 30-40 years of age. Clinically, 87.9% of patients presented with squamous erythema, 37.9% with follicular papules, and 28.8% with palmoplantar hyperkeratosis. Histopathologically, the detection rates of follicular plugging and checkerboard pattern, the classic features of pityriasis rubra pilaris (PRP), were 11.6% and 16.3%, respectively. Characteristic dermatoscopic findings were observed in 82.6% of the 23 patients who underwent dermatoscopy. Regarding treatment outcomes, among conventional therapies, the overall response rate was 43.8% for acitretin, 33.3% for methotrexate, and 25% for cyclosporine, while ustekinumab, a biologic agent, achieved an overall response rate of 81.8%. Conclusion: PRP occurs more frequently in males, with a bimodal age distribution at onset. The predominant clinical presentation is squamous erythema. Classic histopathologic features show low detection rates. Dermatoscopy serves as an effective noninvasive auxiliary tool for diagnosing PRP. Acitretin yields a superior overall response rate compared with other conventional treatments. Ustekinumab demonstrates significant efficacy in the management of refractory PRP.

Key words: pityriasis rubra pilaris, retrospective study, IL-12/23 inhibitors, ustekinumab