Siepmann Dorothee, Luger Thomas A, Ständer Sonja
Clinical Neurodermatology, Department of Dermatology, University of Münster, Münster, Germany.
J Dtsch Dermatol Ges. 2008 Nov;6(11):941-6. doi: 10.1111/j.1610-0387.2008.06745.x. Epub 2008 Apr 28.
Prurigo nodularis shows intense itching nodules, which are often persistent and therapy refractory. Histological alterations include fibrosis of collagen fibers and presence of inflammatory infiltrate, which partly explains the clinical persistence of lesions. Inflammatory cells may directly contribute to induction and maintenance of pruritus at nerve fibers. Cyclosporine microemulsion (ME) suppresses the migration and proliferation of inflammatory cells and may thereby interfere with pathogenesis of prurigo nodularis. The aim of this investigation was to assess the antipruritic efficiency of cyclosporine ME in therapy of prurigo nodularis.
14 patients with prurigo nodularis of diverse origin and failure to previous therapy were treated with oral cyclosporine ME (3 to 5 mg per kg daily). Blood pressure, liver enzymes, renal function and differential blood count were monitored.
In 13 of 14 prurigo patients (92.9 %) there was a significant response to monotherapy with cyclosporine ME. The maximal antipruritic effect occurred after 2 weeks to 12 months. Prurigo nodules also healed during therapy. Seven patients (50.0 %) described side effects. In one case the therapy was stopped.
Oral cyclosporine ME is an effective therapy for prurigo nodularis of diverse origin. It appears to function by inhibiting dermal inflammatory cells.
结节性痒疹表现为剧烈瘙痒的结节，通常持续存在且治疗难治。组织学改变包括胶原纤维纤维化和炎性浸润，这部分解释了皮损的临床持续性。炎性细胞可能直接导致神经纤维瘙痒的诱发和维持。环孢素微乳剂（ME）可抑制炎性细胞的迁移和增殖，从而可能干扰结节性痒疹的发病机制。本研究的目的是评估环孢素ME治疗结节性痒疹的止痒效果。
14例不同病因且先前治疗无效的结节性痒疹患者接受口服环孢素ME治疗（每日每千克体重3至5毫克）。监测血压、肝酶、肾功能和血常规。
14例结节性痒疹患者中有13例（92.9%）对环孢素ME单一疗法有显著反应。最大止痒效果出现在2周后至12个月。治疗期间结节性痒疹结节也愈合。7例患者（50.0%）描述有副作用。1例患者停止治疗。
口服环孢素ME是治疗不同病因结节性痒疹的有效疗法。其作用似乎是通过抑制真皮炎性细胞实现的。
