Stratigos A J, Antoniou C, Stamathioudaki S, Avgerinou G, Tsega A, Katsambas A D
Department of Dermatology, University of Athens Medical School, Andreas Sygros Hospital, Athens, Greece.
Clin Exp Dermatol. 2004 Mar;29(2):150-3. doi: 10.1111/j.1365-2230.2004.01471.x.
Lupus erythematosus-like syndromes have been reported as an adverse effect of anti-tumour necrosis factor-alpha therapy. We report the case of a patient with rheumatoid arthritis who developed a discoid lupus erythematosus-like eruption after treatment with infliximab. The rash consisted of diffuse scaly erythematous plaques on the face, trunk and extremities, and occurred in the context of elevated anti-nuclear and anti-double-stranded DNA antibody titres. Direct immunofluorescence of lesional skin showed linear deposition of IgG, IgM and C3. The lesions resolved completely after the discontinuation of infliximab and with the use of anti-malarial therapy. We discuss the clinical, histological and immunohistochemical features of this case and review the literature with respect to the incidence of lupus erythematosus-like syndromes in patients receiving tumour necrosis factor-alpha antagonists.
红斑狼疮样综合征已被报道为抗肿瘤坏死因子-α治疗的一种不良反应。我们报告了1例类风湿关节炎患者，在用英夫利昔单抗治疗后出现了盘状红斑狼疮样皮疹。皮疹表现为面部、躯干和四肢弥漫性鳞屑性红斑斑块，且发生于抗核抗体和抗双链DNA抗体滴度升高的情况下。皮损皮肤的直接免疫荧光显示IgG、IgM和C3呈线性沉积。停用英夫利昔单抗并使用抗疟治疗后，皮损完全消退。我们讨论了该病例的临床、组织学和免疫组化特征，并就接受肿瘤坏死因子-α拮抗剂治疗的患者中红斑狼疮样综合征的发生率进行了文献复习。
