Sfia M, Roth-Mall B, Tortel M-C, Guillaume J-C, Cribier B
Service de dermatologie, hôpital Pasteur, 39, avenue de la Liberté, 68024 Colmar cedex, France.
Ann Dermatol Venereol. 2009 Dec;136(12):898-903. doi: 10.1016/j.annder.2009.09.011.
Blaschko-linear psoriasis is a rare disease about which only a few publications have appeared in the literature. This form of psoriasis poses problems of differential diagnosis with regard to other forms of inflammatory Blaschko-linear dermatoses. Herein, we report an original case, the linear nature of which was revealed by treatment with infliximab.
A 29-year-old man presented chronic psoriasis present for 17 years and resistant to various forms of systemic therapy. Treatment with infliximab 5mg/kg given on D1, D15 and two-monthly, thereafter resulted in practically complete resolution of all skin lesions after the fourth infusion. The only remaining lesions were psoriatic erythematous-squamous, non-pustular lesions with a Blaschko-linear pattern, limited to one side, on the left arm and left leg. These lesions persisted after 10 courses of infliximab, although no other lesions reappeared.
This case was original in terms of the revelation of Blaschko-linear lesions during treatment with infliximab, despite the complete disappearance of diffuse psoriatic plaques, thus suggesting the existence in this patient of two cell populations, each having a different response to biotherapy.
线状银屑病是一种罕见疾病，文献中仅有少数相关报道。这种银屑病形式在与其他形式的炎症性线状皮肤病的鉴别诊断方面存在问题。在此，我们报告一例原发病例，其线状特征通过英夫利昔单抗治疗得以显现。
一名29岁男性，患慢性银屑病17年，对各种形式的全身治疗均耐药。在第1天、第15天给予英夫利昔单抗5mg/kg，此后每两个月给药一次，第四次输注后几乎所有皮肤损害均完全消退。仅残留的损害为银屑病性红斑鳞屑性、非脓疱性损害，呈线状分布，局限于左臂和左腿的一侧。尽管进行了10个疗程的英夫利昔单抗治疗，这些损害依然存在，不过未再出现其他损害。
该病例的独特之处在于，尽管弥漫性银屑病斑块完全消失，但在英夫利昔单抗治疗期间线状损害却显现出来，这表明该患者体内存在两种细胞群，各自对生物治疗有不同反应。
