Casoni Federica, Merelli Elisa, Bedin Roberta, Martella Alessandro, Cesinaro Anna, Bertolotto Antonio
Clinica Neurologica, Policinico, Via Del Pozzo 71, 41100 Modena, Italy.
Mult Scler. 2003 Aug;9(4):420-3. doi: 10.1191/1352458503ms933sr.
A case of a severe necrotizing vasculopathic skin lesions occurred in a 43 year old women affected by multiple sclerosis (MS) submitted to IFNbeta-1b has been described. After two months of therapy the patient presented, in injection sites of the abdomen, arms and legs, numerous ulcers. A biopsy of the lesions was performed and evidenced confluent necrosis of the superficial and deep skin tissue with mild infiltration by inflammatory cells and thrombosis in deep blood vessels. The IFNbeta-1b was immediately discontinued and therapy with corticosteroids was started. After 12 months from the onset of the adverse reaction, the skin vasculopathic lesions cicatrised leaving sclerotic areas on the abdomen. Neutralizing antibodies against IFNbeta-1b (NABs) were strongly positive at the onset of the skin ulcers and slowly decreased until the recovery. A possible role of NABs in the development of the skin lesions has been considered.
描述了一例43岁患有多发性硬化症（MS）且接受β-1b干扰素治疗的女性发生严重坏死性血管病性皮肤病变的病例。治疗两个月后，患者在腹部、手臂和腿部的注射部位出现了大量溃疡。对病变进行了活检，结果显示浅表和深部皮肤组织融合性坏死，伴有轻度炎症细胞浸润和深部血管血栓形成。立即停用β-1b干扰素，并开始使用皮质类固醇进行治疗。不良反应出现12个月后，皮肤血管病性病变愈合，但腹部留下了硬化区域。皮肤溃疡发作时，抗β-1b干扰素中和抗体（NABs）呈强阳性，直至恢复过程中逐渐缓慢下降。已考虑NABs在皮肤病变发展中的可能作用。
