Mekkes J R, Bos J D
Department of Dermatology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Br J Dermatol. 2008 Feb;158(2):370-4. doi: 10.1111/j.1365-2133.2007.08332.x. Epub 2007 Nov 28.
Hidradenitis suppurativa is a chronic inflammatory skin disease characterized by abscess formation, predominantly in the axillae and groins. The disease is difficult to treat and has a severe impact on quality of life. Recently, several case reports have been published describing successful treatment of hidradenitis suppurativa with infliximab and other tumour necrosis factor alpha inhibitors.
To evaluate the long-term efficacy of a single course of infliximab.
Ten patients with severe, recalcitrant hidradenitis were treated with infliximab (three infusions of 5 mg kg(-1) at weeks 0, 2 and 6) and followed up for at least 1 year. The disease activity was measured using laboratory parameters and a recently developed acne score. The patients rated the efficacy of infliximab on a 10-point scale at regular intervals. Quality of life was measured before and after treatment using the Dermatology Quality of Life Index (DQLI).
All patients improved within 2-6 weeks. The average acne score diminished from 164+/-50 (mean+/-SD) before treatment to 89+/-49 after 1 year (P=0.002). The mean CRP (C-reactive protein) was reduced from 31.7 mg mL(-1) to 5.5 mg mL(-1) after 1 month (P=0.015). Patients judged the efficacy with a score of 7.9. The mean DQLI was reduced from 18.4+/-7.9 before treatment to 9.3+/-9.1 after 1 year (P=0.007). In three patients long-lasting improvement was observed, with no recurrence of lesions in a 2-year follow-up period. The other patients showed recurrence of lesions after 8.5 months (range 4.3-13.4 months).
Infliximab is an effective treatment in severe hidradenitis suppurativa, leading to reduction of symptoms for a prolonged period.
化脓性汗腺炎是一种慢性炎症性皮肤病，其特征为脓肿形成，主要发生在腋窝和腹股沟。该病难以治疗，对生活质量有严重影响。最近，有几篇病例报告发表，描述了英夫利昔单抗和其他肿瘤坏死因子α抑制剂成功治疗化脓性汗腺炎的情况。
评估单次英夫利昔单抗疗程的长期疗效。
10例重度、顽固性化脓性汗腺炎患者接受英夫利昔单抗治疗（在第0、2和6周各输注3次，剂量为5 mg/kg），并随访至少1年。使用实验室指标和最近开发的痤疮评分来衡量疾病活动度。患者定期以10分制对英夫利昔单抗的疗效进行评分。治疗前后使用皮肤病生活质量指数（DQLI）来衡量生活质量。
所有患者在2至6周内病情均有改善。平均痤疮评分从治疗前的164±50（均值±标准差）降至1年后的89±49（P=0.002）。1个月后，平均C反应蛋白（CRP）从31.7 mg/mL降至5.5 mg/mL（P=0.015）。患者对疗效的评分为7.9分。平均DQLI从治疗前的18.4±7.9降至1年后的9.3±9.1（P=0.007）。3例患者观察到长期改善，在2年随访期内病变未复发。其他患者在8.5个月（范围4.3 - 13.4个月）后病变复发。
英夫利昔单抗是治疗重度化脓性汗腺炎的有效方法，可使症状长期减轻。
