Manoharan Shobhan, White Stephen, Gumparthy Krishna
Department of Dermatology, Wirral Hospital NHS Trust, Clatterbridge Hospital, Bebington Wirral, England, UK.
Australas J Dermatol. 2006 May;47(2):124-9. doi: 10.1111/j.1440-0960.2006.00247.x.
A 59-year-old woman presented with a painful, pruritic eruption that had commenced as an erythematous, dry patch on the upper back but progressed to erythroderma. Examination revealed orange-tinged erythroderma, scalp scaling, ectropion, palmoplantar keratoderma and nail changes. A diagnosis of type I adult-onset pityriasis rubra pilaris was made, and a subsequent skin biopsy was consistent with this. She was treated with a number of topical and systemic agents with minimal improvement or major side-effects. The patient was then treated with intravenous infliximab 5 mg/kg. She improved dramatically within 2 weeks and was no longer erythrodermic. Five further infusions resulted in additional improvement. Methotrexate was briefly added to the regime, but was ceased owing to nausea. Topical tar and keratolytics were used on the scalp. The patient was left with minimal disease activity and was maintained on emollients.
一名59岁女性出现疼痛、瘙痒性皮疹，起初为上背部的红斑、干燥斑块，后发展为红皮病。检查发现橙红色红皮病、头皮脱屑、睑外翻、掌跖角化病和指甲改变。诊断为I型成人起病的毛发红糠疹，随后的皮肤活检结果与之相符。她接受了多种局部和全身用药治疗，但改善甚微或出现严重副作用。随后患者接受静脉注射英夫利昔单抗5mg/kg治疗。2周内病情显著改善，不再有红皮病表现。再进行5次输注后病情进一步好转。治疗方案中曾短期加用甲氨蝶呤，但因恶心而停用。头皮使用了焦油和角质剥脱剂。患者病情活动度降至最低，使用润肤剂维持治疗。
