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NEJM：做心电图导致的Koebner现象-病例报道

2017-11-30 xing.T MedSci原创

瘙痒银屑病Koebner现象
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对于银屑病患者，刺激因素包括药物、感染、局部刺激甚至心理压力等可能引发这种慢性炎症性疾病的复发。Koebner现象，也被称为同形反应，其特点是在机械性刺激后可以出现新的皮损。

患者为一名53岁男性，既往有20年以上的银屑病病史，因想进一步治疗恶化的瘙痒和银屑病皮损而到皮肤科就诊。

该患者的症状曾外用卡泊三醇和倍他米松也无法控制。由于副作用，不得不停止采用全身富马酸和氨甲喋呤的治疗。在这次就诊前三周，患者进行了心电图（ECG）检查，2周后，在放置心电图电极的部位出现了新的皮肤病变。



皮肤检查时在躯干、手臂、腿部和头皮上也发现了清晰可见的、大小不一的红色斑块，伴有银色鳞片。

对于银屑病患者，刺激因素包括药物、感染、局部刺激甚至心理压力等可能引发这种慢性炎症性疾病的复发。Koebner现象，也被称为同形反应，其特点是在机械性刺激后可以出现新的皮损。

该患者接受了阿达木单抗治疗后，治疗起效迅速，所有银屑病皮损均愈合。

原始出处：

Enrico Streit,et al. ECG-Induced Koebner Phenomenon. N Engl J Med 2017; http://www.nejm.org/doi/full/10.1056/NEJMicm1706993

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    2018-04-28 ms8435843352634314

    #Koebner现象#

    0

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    2017-12-02 txqjm

    学习了.学习

    0

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    2017-12-02 麻醉僧

    学习

    0

  4. 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createdBy=30331616752, createdName=txqjm, createdTime=Sat Dec 02 07:32:58 CST 2017, time=2017-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266054, encodeId=d8af266054dc, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/27/e6ae4d6996235d5b5d2f416737192359.jpg, createdBy=ba621669454, createdName=麻醉僧, createdTime=Sat Dec 02 00:05:11 CST 2017, time=2017-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=265920, encodeId=1944265920db, content=学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLC1BMzZWdMSPQWuib6BtQGicK8ygGBM6YakpfkRc67soFSuKbZr86enL1KggQZEZbgWSeicJibafmYfQ3AibicIHMwwicmDShfRFvvI38/0, createdBy=272a110164, createdName=laoli, createdTime=Fri Dec 01 10:34:40 CST 2017, time=2017-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=265711, encodeId=e1fb265e11ab, content=学习了.涨知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Thu Nov 30 15:40:10 CST 2017, time=2017-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=265556, encodeId=7e4926555612, content=不错的.学习了.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdqKgfW3nMpOkC3jXxiaW2po0PtglY5ZuVjERqKADW4HyMI8bcZXWlKgH7tEP9ULBoBzuQMibia4pr1s9rQPqLvqQJ/0, createdBy=e8c02060444, createdName=中医痴, createdTime=Thu Nov 30 08:41:17 CST 2017, time=2017-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=265540, encodeId=fc7726554021, content=学习啦!谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Thu Nov 30 07:53:38 CST 2017, time=2017-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=265532, encodeId=acbe2655324c, content=写的很好.认真学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo61WAV0ROeLAoicPxPKoKaogwLWLL8STv86qplbdOibN2YR4KxkJicqNectCXGR8gPJhGLc7yYLSdnpx4kaVXndTfu/0, createdBy=a6962042337, createdName=1391e9f2a7m, createdTime=Thu Nov 30 07:41:43 CST 2017, time=2017-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=265527, encodeId=4eea26552ea2, content=学习了分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/21/39b6a0099eb602e8ac1f7e10d5d440a9.jpg, createdBy=dee01724555, createdName=杨利洪, createdTime=Thu Nov 30 07:34:22 CST 2017, time=2017-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=265517, encodeId=8f1126551e94, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Thu Nov 30 07:19:29 CST 2017, time=2017-11-30, status=1, ipAttribution=)]
    2017-12-01 laoli

    学习了.谢谢分享!

    0

  5. 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    2017-11-30 1ddf0692m34(暂无匿称)

    学习了.涨知识

    0

  6. 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GetPortalCommentsPageByObjectIdResponse(id=265517, encodeId=8f1126551e94, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Thu Nov 30 07:19:29 CST 2017, time=2017-11-30, status=1, ipAttribution=)]
    2017-11-30 中医痴

    不错的.学习了.谢谢分享!

    0

  7. 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GetPortalCommentsPageByObjectIdResponse(id=265517, encodeId=8f1126551e94, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Thu Nov 30 07:19:29 CST 2017, time=2017-11-30, status=1, ipAttribution=)]
    2017-11-30 tanxingdoctor

    学习啦!谢谢分享!

    0

  8. 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    2017-11-30 1391e9f2a7m

    写的很好.认真学习

    0

  9. 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    2017-11-30 杨利洪

    学习了分享了

    0

  10. 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    2017-11-30 榄枷檬

    谢谢分享

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