Dalmau Joan, Pimentel Carmen Lucia, Puig Luis, Peramiquel Laura, Roé Esther, Alomar Agustin
Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
J Am Acad Dermatol. 2005 Jul;53(1):62-6. doi: 10.1016/j.jaad.2005.02.031.
Pegylated interferon alfa-2b is a formulation of recombinant human interferon conjugated with polyethylene glycol. Compared with standard interferon alfa injections, this preparation has a longer half-life allowing for once-weekly injections and superior antiviral efficacy in the treatment of hepatitis C when used in combination with ribavirin. Cutaneous side effects caused by interferon are well known. Cutaneous necrosis as a result of interferon alfa is an infrequent complication with unknown pathogenesis, in which a cutaneous local immune-mediated inflammatory process might be involved. We report 5 patients (3 patients with chronic hepatitis C treated with pegylated interferon alfa-2b in association with oral ribavirin and two patients with chronic myelocytic leukemia) who developed local cutaneous reactions at sites of injection after the administration of weekly subcutaneous injections of pegylated interferon alfa-2b at different doses. The ulcers slowly healed with local therapy, but two patients required dose modification of the pegylated interferon alfa-2b and one patient required treatment withdrawal. We review the literature on previously reported cases of cutaneous necrosis after injection of standard interferon alfa or pegylated interferon alfa-2b and discuss the different pathophysiologic mechanisms that might be involved.
聚乙二醇化干扰素α-2b是一种与聚乙二醇结合的重组人干扰素制剂。与标准干扰素α注射剂相比，这种制剂半衰期更长，允许每周注射一次，并且在与利巴韦林联合使用时，治疗丙型肝炎具有更高的抗病毒疗效。干扰素引起的皮肤副作用是众所周知的。α干扰素导致的皮肤坏死是一种罕见的并发症，发病机制不明，可能涉及皮肤局部免疫介导的炎症过程。我们报告了5例患者（3例慢性丙型肝炎患者接受聚乙二醇化干扰素α-2b联合口服利巴韦林治疗，2例慢性粒细胞白血病患者），他们在每周皮下注射不同剂量的聚乙二醇化干扰素α-2b后，注射部位出现局部皮肤反应。溃疡经局部治疗后缓慢愈合，但2例患者需要调整聚乙二醇化干扰素α-2b的剂量，1例患者需要停药。我们回顾了先前报道的注射标准干扰素α或聚乙二醇化干扰素α-2b后皮肤坏死病例的文献，并讨论了可能涉及的不同病理生理机制。
