Lestre Sara, Trindade Felicidade, Martins Andrea, Baptista Juliana, Feio Ana Barata, Lopes Maria João Paiva
Internato Complementar de Dermatovenereologia, Serviço de Dermatologia, Hospital de Santo António dos Capuchos, Alameda Santo António dos Capuchos, Lisboa.
Acta Reumatol Port. 2009 Oct-Dec;34(4):633-40.
Behçet's disease (BD) is chronic, relapsing and multisystem inflammatory disorder, whose diagnosis is essentially clinical. In recent studies, the antagonists of tumor necrosis factor alpha have shown good results in the treatment of mucocutaneous manifestations of BD. The authors describe three cases of BD with serious mucocutaneous involvement treated with infliximab. CLINICAL CASE 1: A 16-year-old female patient with an 8-year history of severe bipolar aphtosis. A rapid clinical response to biological therapy was verified, with partial and total remission of ulcers at 2nd and 6th week of treatment, respectively. CLINICAL CASE 2: A 56-year-old female patient with chronic nodular panniculitis of lower limbs, arthralgias and orogenital ulceration. After 6 weeks of treatment with infliximab, a complete clinical remission was observed. CLINICAL CASE 3: A 50-year-old female with a 15-year history of relapsing oropharyngeal ulceration. A good clinical response to biologic therapy was observed. At 22nd week it was interrupted because frequent dental abscesses. In our experience, infliximab is an effective therapeutic alternative that should be considered in the presence of mucocutaneous manifestations resistant to conventional therapies.
白塞病（BD）是一种慢性、复发性多系统炎症性疾病，其诊断主要依靠临床症状。近期研究表明，肿瘤坏死因子α拮抗剂在治疗白塞病的皮肤黏膜表现方面取得了良好效果。作者描述了3例皮肤黏膜受累严重的白塞病患者，使用英夫利昔单抗进行治疗。临床病例1：一名16岁女性患者，有8年严重复发性口腔溃疡病史。证实对生物治疗有快速临床反应，治疗第2周和第6周时溃疡分别部分和完全缓解。临床病例2：一名56岁女性患者，患有下肢慢性结节性脂膜炎、关节痛和口生殖器溃疡。英夫利昔单抗治疗6周后，观察到临床完全缓解。临床病例3：一名50岁女性，有15年复发性口咽溃疡病史。观察到对生物治疗有良好临床反应。在第22周时因频繁发生牙脓肿而中断治疗。根据我们的经验，英夫利昔单抗是一种有效的治疗选择，对于对传统治疗耐药的皮肤黏膜表现患者应予以考虑。
