Bechtel Mark, Sanders Catherine, Bechtel Ann
The Ohio State University College of Medicine, Columbus, Ohio.
J Clin Aesthet Dermatol. 2009 Nov;2(11):27-32.
Biologic agents have been a significant advancement in the management of psoriasis. Along with significant clinical improvement, there have been concerns for emerging side effects with the use of biologics. Reports have emerged showing the association between efalizumab and the development of progressive multifocal leukoencephalopathy and other demyelinating disorders. Tumor necrosis factor-alpha inhibitors have been associated with various demyelinating disorders. As such, it is imperative for dermatologists to be well informed regarding how to notify patients about the risks of biologic treatment. Dermatologists must be able to identify the signs and symptoms of neurological complications and recognize when to refer patients to neurologists for diagnostic workup, disease confirmation, and any necessary treatment. This review is a compilation of evidence showing the association between biologic therapy and neurological complications, as well as an overview of the clinical presentation and diagnosis of such diseases.
生物制剂在银屑病的治疗方面取得了重大进展。随着显著的临床改善，使用生物制剂引发的副作用也引发了关注。有报告显示依法利珠单抗与进行性多灶性白质脑病及其他脱髓鞘疾病的发生有关。肿瘤坏死因子-α抑制剂也与各种脱髓鞘疾病有关。因此，皮肤科医生必须充分了解如何告知患者生物治疗的风险。皮肤科医生必须能够识别神经并发症的体征和症状，并知道何时将患者转诊给神经科医生进行诊断检查、疾病确诊及任何必要的治疗。本综述汇编了显示生物治疗与神经并发症之间关联的证据，以及此类疾病的临床表现和诊断概述。
