毛周角化病的临床诊疗与研究进展

Clinical Diagnosis, Treatment and Research Progress of Keratosis Pilaris

摘要: 毛周角化病(KP)也被称作毛发苔藓，是较为常见的一类过度角化性皮肤病。它主要表现为毛囊口处的小丘疹且伴随程度不一的毛囊周围红斑，我们针对这类常见又常让人困扰的疾病，从发病机制、症状表现以及治疗手段等方面开展了最新的梳理总结，研究发现毛周角化病归属于毛囊角化性疾病谱系，其中单纯型毛周角化病最为多见，其他变异型与罕见亚型则有红色毛周角化病、面颈部毛囊性红斑黑变病以及萎缩性毛周角化病相关谱系，FLG基因与ABCA12基因发生遗传突变是引发该病的核心因素，毛周角化病或许和寻常型鱼鳞病联系紧密与特应性皮炎的关联则可能性偏低，毛周角化病需重点鉴别的病症有棘状苔藓病以及寻常性鱼鳞病等。日常皮肤护理手段有做好皮肤保湿、避免长时间泡澡或淋浴，最好选用性质温和的香皂或清洁产品，外用角质剥脱剂属于首选治疗方案，后续可搭配外用维A酸类药物，若患者经局部治疗后效果不佳，还可以选择各类激光治疗与微晶磨皮术。

Abstract: Keratosis pilaris (KP), also known as lichen pilaris, is a relatively common type of hyperkeratotic skin disease. It is mainly characterized by small papules at the hair follicle orifices accompanied by varying degrees of perifollicular erythema. We have conducted the latest review and summary on this common and often troublesome disease in terms of pathogenesis, clinical manifestations, and treatment methods. The study found that keratosis pilaris belongs to the spectrum of follicular keratotic diseases, among which the simple type of keratosis pilaris is the most common. Other variants and rare subtypes include erythromelanosis follicularis faciei, atrophicans-related spectrum, and keratosis pilaris rubra. Genetic mutations in the FLG gene and the ABCA12 gene are the core factors causing this disease. Keratosis pilaris may be closely related to ichthyosis vulgaris, but its association with atopic dermatitis is less likely. The diseases that need to be mainly differentiated from keratosis pilaris include lichen spinulosus, pituitary tumor disease, and ichthyosis vulgaris. Daily skin care measures, such as maintaining skin moisture, avoiding long baths or showers, and preferably using mild soaps or cleaning products, are important. Topical keratolytics are the first-line treatment, which can be followed by topical retinoids. If the patient’s response to local treatment is poor, various laser treatments and microdermabrasion can also be considered.