Université de Strasbourg, Faculté de Médecine et Clinique Dermatologique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France. dlipsker @ gmail.com
Dermatology. 2010;220(3):264-7. doi: 10.1159/000280436. Epub 2010 Mar 2.
The treatment of neutrophilic panniculitis can be challenging. We report a patient with a difficult-to-treat neutrophilic panniculitis who had a spectacular response to a short treatment course with the IL-1 antagonist anakinra. A 61-year-woman had a 12-year history of a serious febrile neutrophilic panniculitis and a personal history of steroid-induced pancreatitis and life-threatening methemoglobinemia under antimalarials and dapsone. When she developed a new flare, she was treated successfully with a 15-day course of subcutaneously administered injections of 100 mg anakinra. This observation is the first report attesting the efficiency of anakinra in neutrophilic panniculitis. It expands the potential indications of IL-1 inhibition in the field of the neutrophilic dermatoses, or more generally, in neutrophil-mediated systemic diseases. It underscores the potential pathogenic involvement of IL-1 in those diseases, a hallmark of autoinflammation, and supports their nosologic classification among diseases involving primarily the innate immune system.
中性粒细胞性脂膜炎的治疗具有挑战性。我们报告了一例治疗困难的中性粒细胞性脂膜炎患者，该患者接受白细胞介素 1 拮抗剂阿那白滞素短程治疗后取得了显著疗效。一名 61 岁女性患有严重发热性中性粒细胞性脂膜炎，且有皮质类固醇诱导的胰腺炎病史和在使用抗疟药和氨苯砜时发生危及生命的高铁血红蛋白血症病史。当她出现新的发作时，成功地接受了 15 天的皮下注射 100 毫克阿那白滞素治疗。这一观察结果首次证明了阿那白滞素在中性粒细胞性脂膜炎中的疗效。它扩大了白细胞介素 1 抑制在中性粒细胞性皮肤病领域的潜在适应证，或更广泛地说，在中性粒细胞介导的全身性疾病中的潜在适应证。它强调了白细胞介素 1 在这些疾病中的潜在致病作用，这是自身炎症的一个标志，并支持它们在主要涉及固有免疫系统的疾病中的分类。
