Mlczoch Lila, Attarbaschi Andishe, Dworzak Michael, Gadner Helmut, Mann Georg
St. Anna Children's Hospital, Vienna, Austria.
Leuk Lymphoma. 2005 Apr;46(4):623-7. doi: 10.1080/10428190500032570.
A 17-year-old girl presented with a 3 month history of alopecia areata, a generalized scaling skin, enlargement of the inguinal lymph nodes and severe back pain. Staging procedures revealed multifocal bone disease and generalized lymphadenopathy. The diagnosis of nodular sclerosing Hodgkin's disease was established by biopsies of the os ileum and a left inguinal lymph node. Complete clinical remission was achieved after 2 OPPA (vincristine, prednisone, procarbazine, and doxorubicin) and 4 COPP (cyclophosphamide, vincristine, prednisone, and procarbazine) cycles and treatment completed with involved-field irradiation. After the completion of therapy, skeletal lesions had mostly resolved or become sclerotic and the patient had normal hair regrowth and skin appearance. Conclusively, this case illustrates that alopecia areata may occur as a paraneoplastic phenomenon or an autoimmune process related to the deranged cellular immune system in children and adolescents with Hodgkin's disease.
一名17岁女孩出现斑秃3个月，伴有全身皮肤脱屑、腹股沟淋巴结肿大及严重背痛。分期检查发现多灶性骨病和全身淋巴结病。通过回肠活检和左侧腹股沟淋巴结活检确诊为结节硬化型霍奇金病。经过2个OPPA（长春新碱、泼尼松、丙卡巴肼和阿霉素）和4个COPP（环磷酰胺、长春新碱、泼尼松和丙卡巴肼）周期化疗，并完成受累野放疗后，实现了完全临床缓解。治疗结束后，骨骼病变大多已消退或硬化，患者头发正常再生，皮肤外观恢复正常。总之，该病例表明斑秃可能作为一种副肿瘤现象或与霍奇金病儿童及青少年紊乱的细胞免疫系统相关的自身免疫过程而出现。
