Paul M, Cribier B, Heid E, Grosshans E, Lipsker D
Clinique Dermatologique des Hôpitaux Universitaires de Strasbourg.
Ann Dermatol Venereol. 2004 Dec;131(12):1051-4. doi: 10.1016/s0151-9638(04)93839-2.
Granuloma have already been described in the context of immunosuppression. We report six cases of widespread granuloma annulare occurring in patients with drug-induced immunosuppression.
There were four women and two men, with mean age of 61 years (35-76). Three patients were treated with chemotherapy for breast (2 cases) and liver cancer. One woman was given chemotherapy for Hodgkin's disease. One had undergone liver transplantation and was given cyclosporine, another was treated with systemic steroids for polyarthritis. All had generalized non-photoexposed granuloma annulare, composed of multiple erythematous papules, sometimes with annular pattern. The lesions were localized on the trunk, legs and arms. Histopathology revealed granuloma annulare in each patient.
These six cases suggest a relationship between drug-induced immunodeficiency and generalized granuloma annulare. The immune dysregulation induced by the drugs may have been responsible for the formation of granuloma annulare.
肉芽肿已在免疫抑制的背景下被描述过。我们报告6例发生在药物性免疫抑制患者中的播散性环状肉芽肿病例。
4名女性和2名男性，平均年龄61岁（35 - 76岁）。3例患者因乳腺癌（2例）和肝癌接受化疗。1名女性因霍奇金病接受化疗。1例接受了肝移植并服用环孢素，另1例因多关节炎接受全身类固醇治疗。所有患者均有泛发性非曝光部位的环状肉芽肿，由多个红斑丘疹组成，有时呈环状。皮损位于躯干、腿部和手臂。组织病理学显示每例患者均为环状肉芽肿。
这6例病例提示药物性免疫缺陷与泛发性环状肉芽肿之间存在关联。药物诱导的免疫失调可能是环状肉芽肿形成的原因。
