Batchelor Jonathan M, Todd Pamela M
Queen's Medical Centre, Nottingham, United Kingdom.
J Drugs Dermatol. 2012 Feb;11(2):256-9.
The authors report a female patient with recalcitrant ulcerated necrobiosis lipoidica (NL) that was resistant to numerous systemic agents and who responded to treatment with intravenous immunoglobulin (IVIG), leading to resolution of the ulcerated areas for several months. Subsequent treatment with two further courses of IVIG was less effective, but a course of intravenous methylprednisolone led to regression of the lesions. As well as briefly reviewing the literature on treatments used to treat ulcerated NL, we outline the pathological mechanisms thought to be involved in the condition and how the modes of action of IVIG might explain its apparent efficacy in this case. As far as we are aware, the response of ulcerated NL to IVIG or methylprednisolone has not been reported previously, although other systemic preparations of corticosteroids have been used.
作者报告了一名患有顽固性溃疡性类脂质渐进性坏死（NL）的女性患者，该患者对多种全身用药均耐药，但对静脉注射免疫球蛋白（IVIG）治疗有反应，溃疡区域得以愈合数月。随后再进行两个疗程的IVIG治疗效果较差，但静脉注射甲泼尼龙一个疗程导致病变消退。除了简要回顾用于治疗溃疡性NL的治疗方法的文献外，我们概述了被认为与该病有关的病理机制，以及IVIG的作用方式如何解释其在该病例中的明显疗效。据我们所知，尽管之前曾使用过其他全身性皮质类固醇制剂，但溃疡性NL对IVIG或甲泼尼龙的反应此前尚未见报道。
