Horn T D, Burke P J, Karp J E, Hood A F
Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Md.
Arch Dermatol. 1991 Jan;127(1):49-52.
The intravenous administration of recombinant human granulocyte-macrophage colony-stimulating factor to three patients with leukemia who were receiving marrow aplasia-inducing chemotherapy resulted in the development of wide-spread erythematous macules and papules. The course of the eruption paralleled the time of infusion of the granulocyte-macrophage colony-stimulating factor. Skin biopsy specimens taken from two of the eruptions displayed characteristic changes consisting of a variable mixture of granulocytes and lymphocytes, increased number and size of dermal macrophages, mild to moderate epidermal exocytosis, intercellular edema, and rare dyskeratotic keratinocytes. Immunophenotypic analysis of one specimen was notable for keratinocyte intercellular adhesion molecule-1 expression. Administration of the recombinant human cytokine in pharmacologic doses is postulated to induce changes in the immunologic status of the skin, resulting in the expression of a cutaneous eruption.
对三名正在接受诱导骨髓再生障碍化疗的白血病患者静脉注射重组人粒细胞巨噬细胞集落刺激因子后，出现了广泛的红斑性斑疹和丘疹。皮疹的病程与粒细胞巨噬细胞集落刺激因子的输注时间平行。从其中两处皮疹获取的皮肤活检标本显示出特征性变化，包括粒细胞和淋巴细胞的不同混合、真皮巨噬细胞数量和大小增加、轻度至中度表皮细胞外渗、细胞间水肿以及罕见的角化不良角质形成细胞。对一份标本的免疫表型分析显示角质形成细胞间粘附分子-1表达明显。推测以药理剂量给予重组人细胞因子会诱导皮肤免疫状态发生变化，从而导致皮肤皮疹的出现。
