Seishima M, Izumi T, Kanoh H
Department of Dermatology, Ogaki Municipal Hospital, Minaminokawa-cho 4-86, Ogaki City, 503-8502, Japan.
Eur J Dermatol. 2000 Jan-Feb;10(1):55-8.
We describe a 50-year-old woman who noted acral hyperpigmentation, sclerodactyly and Raynaud's phenomenon with 1:160 of antinuclear antibody titer after treatment with a compound drug with tegafur and uracil. Histological findings of the finger and palm included hyperkeratosis, vacuolar degeneration of basal cells, thickened collagen fibers in the dermis, and dilatation of capillary vessels, perivascular mononuclear cell infiltration and melanophages in the upper dermis. IgG, IgA, IgM, C3 and C1q were not deposited in the skin by direct immunofluorescence study. After cessation of the drug, Raynaud's phenomenon and hyperpigmentation disappeared within 1 month and 4 months, respectively, and antinuclear antibody turned negative within 4 months. These observations suggest that tegafur may have caused not only hyperpigmentation in the palms and soles, but also sclerodactyly and Raynaud's phenomenon in the present case.
我们描述了一名50岁女性,在用替加氟尿嘧啶复方药物治疗后出现肢端色素沉着、指端硬化和雷诺现象,抗核抗体滴度为1:160。手指和手掌的组织学检查结果包括角化过度、基底细胞空泡变性、真皮层胶原纤维增厚、毛细血管扩张、血管周围单核细胞浸润以及真皮上层的噬黑素细胞。直接免疫荧光研究显示IgG、IgA、IgM、C3和C1q未沉积于皮肤。停药后,雷诺现象和色素沉着分别在1个月和4个月内消失,抗核抗体在4个月内转阴。这些观察结果表明,在本病例中,替加氟不仅可能导致手掌和脚底色素沉着,还可能导致指端硬化和雷诺现象。