Lebas D, Staumont-Sallé D, Solau-Gervais E, Flipo R-M, Delaporte E
Clinique de Dermatologie, Hôpital Claude Huriez, CHRU Lille, Lille Cedex.
Ann Dermatol Venereol. 2007 Apr;134(4 Pt 1):337-42. doi: 10.1016/s0151-9638(07)89187-3.
TNFalpha blockers have recently extended the therapeutic arsenal available in dermatology. However, dermatologists must be informed of their potential adverse dermatological effects. While the chief adverse effect of TNFalpha blockers is risk of infection, cutaneous adverse effects have not yet been clearly elucidated and publications on this topic are few and far between. The aim of our study is to report various dermatological problems noted during treatment with TNFalpha blockers.
This was a retrospective study of patient files. The study population comprised patients receiving TNFalpha blockers and presenting cutaneous reaction, and seen in the dermatology department between August 2001 and December 2004.
Eleven patients were included. The following cutaneous reactions were seen: delayed skin rash (1 case), lupus syndrome (1 case), cutaneous vasculitis (2 cases), palmoplantar pustulosis (2 cases), psoriasis vulgaris (1 case), atopic dermatitis (1 case), lichenoid rash (1 case), purpuric capillaritis (1 case) and melanoma (1 case).
The cutaneous manifestations seen represented a wide range of different clinical pictures. Dermatologists must be aware of these potential adverse effects. Future improvement of knowledge of the physiopathological mechanisms as well as the institution of prospective cohort studies should provide clearer guidance on the management of such symptoms.
肿瘤坏死因子α(TNFα)阻滞剂最近扩充了皮肤病学的治疗手段。然而,皮肤科医生必须了解其潜在的皮肤不良反应。虽然TNFα阻滞剂的主要不良反应是感染风险,但皮肤不良反应尚未得到明确阐释,关于该主题的出版物也寥寥无几。我们研究的目的是报告使用TNFα阻滞剂治疗期间注意到的各种皮肤问题。
这是一项对患者病历的回顾性研究。研究人群包括接受TNFα阻滞剂治疗并出现皮肤反应、于2001年8月至2004年12月在皮肤科就诊的患者。
纳入了11名患者。观察到以下皮肤反应:迟发性皮疹(1例)、狼疮综合征(1例)、皮肤血管炎(2例)、掌跖脓疱病(2例)、寻常型银屑病(1例)、特应性皮炎(1例)、苔藓样皮疹(1例)、紫癜性毛细血管炎(1例)和黑色素瘤(1例)。
观察到的皮肤表现代表了广泛的不同临床情况。皮肤科医生必须意识到这些潜在的不良反应。未来对生理病理机制认识的提高以及前瞻性队列研究的开展应能为这类症状的管理提供更清晰的指导。