Poulin Frédéric, Rico Philippe, Côté Jean, Bégin Louis R
Hôpital du Sacré-Coeur de Montréal, Department of Internal Medicine, 5400 Gouin Blvd W, Montréal, Québec, Canada H4J 1C5.
Arch Dermatol. 2009 Aug;145(8):916-7. doi: 10.1001/archdermatol.2009.106.
As immunomodulatory therapies such as recombinant human interferon beta gain clinical applicability, patients are likely to experience some of their numerous cutaneous adverse effects at injection sites. We describe a case of interferon beta-induced septal panniculitis.
A 43-year-old woman with multiple sclerosis treated with subcutaneous interferon beta presented with right lower abdominal quadrant pain, fever, and an indurated McBurney point. An abdominal computed tomographic scan showed an inflammatory subcutaneous fat infiltration reaching the surface of the right lateral rectus muscle. The patient was brought to the operating room, where a laparoscopic appendectomy was performed. She returned a week later unimproved. The infiltration near a site of subcutaneous injection progressed with areas of liquefaction. Histologic examination of a deep cutaneous biopsy specimen revealed a septal panniculitis without vasculitis.
Panniculitides encompass various clinical syndromes characterized by inflammation of the fibrous septae, fatty lobules, or both components of the subcutaneous tissue. Interferon beta-1b should be considered among the list of putative agents.
随着重组人干扰素β等免疫调节疗法在临床上的应用越来越广泛，患者在注射部位可能会出现多种皮肤不良反应。我们报告一例干扰素β诱导的间隔性脂膜炎病例。
一名43岁接受皮下注射干扰素β治疗的多发性硬化症女性患者，出现右下腹象限疼痛、发热以及麦氏点硬结。腹部计算机断层扫描显示炎性皮下脂肪浸润至右侧腹直肌表面。患者被送往手术室，接受了腹腔镜阑尾切除术。一周后她未见好转。皮下注射部位附近的浸润进展，出现液化区域。深部皮肤活检标本的组织学检查显示为间隔性脂膜炎，无血管炎。
脂膜炎包括各种临床综合征，其特征为纤维间隔、脂肪小叶或皮下组织的这两个组成部分发生炎症。在可能的致病因素中应考虑干扰素β-1b。
