Chong B F, Wong H K
Department of Dermatology, Henry Ford Hospital, Detroit, MI 48202, USA.
Clin Exp Dermatol. 2009 Jul;34(5):e11-3. doi: 10.1111/j.1365-2230.2008.02973.x. Epub 2009 Nov 27.
The use of immunobiologicals that suppress an overly active immune system in psoriasis carries with it the possibility of cancer development as a result of immunosuppression. Patients with a history of malignancy may be at risk for recurrence when treated with immunosuppressive agents. Moreover, autoimmune diseases, such as psoriasis, have been associated with an increased risk of lymphoma. Therefore, risk-benefit assessments must take into account the clinical severity and treatment of psoriasis. We describe a 59-year-old white man with a history of primary B-cell lymphoma, severe recalcitrant plaque-type psoriasis and psoriatic arthritis, who was started on etanercept for treatment of his psoriasis and psoriatic arthritis. The patient has a long history of remission of his lymphoma. After treatment, the patient experienced significant global improvement with essentially complete remission of the cutaneous lesions and arthritis, and had no recurrence of his lymphoma or other systemic complications while on etanercept after follow-up for > 3 years.
在银屑病中使用抑制过度活跃免疫系统的免疫生物制剂，因免疫抑制存在癌症发生的可能性。有恶性肿瘤病史的患者在接受免疫抑制剂治疗时可能有复发风险。此外，自身免疫性疾病，如银屑病，与淋巴瘤风险增加有关。因此，风险效益评估必须考虑银屑病的临床严重程度和治疗情况。我们描述了一名59岁白人男性，有原发性B细胞淋巴瘤病史、严重顽固性斑块型银屑病和银屑病关节炎，开始使用依那西普治疗其银屑病和银屑病关节炎。该患者有淋巴瘤长期缓解史。治疗后，患者整体有显著改善，皮肤病变和关节炎基本完全缓解，在接受依那西普治疗随访超过3年期间，淋巴瘤未复发，也无其他全身并发症。
