Department of Dermatology, Graduate School of Medicine, University of the Ryukyus, Nishihara Chuo Dermatological Office, Naha, Okinawa, Japan.
J Dermatol. 2012 Aug;39(8):711-4. doi: 10.1111/j.1346-8138.2011.01484.x. Epub 2012 Feb 28.
A 58-year-old Japanese man with a 2-year history of multidrug therapy for borderline lepromatous leprosy presented with skin lesions suggestive of erythema nodosum leprosum (ENL) and was treated with an oral corticosteroid. As attempts to taper the oral corticosteroid resulted in the appearance of new lesions, thalidomide was added along with cyclosporin. Two months after the introduction of thalidomide, deep venous thrombosis (DVT) occurred in both legs and anticoagulant therapy was started without cessation of thalidomide. Pulmonary embolism developed 1 month after the appearance of DVT, and these thromboembolic events were believed to be due to thalidomide. This case highlights the need for vigilance against venous thromboembolism when corticosteroid and thalidomide are co-administrated for the treatment of ENL.
一位 58 岁的日本男性，患有边界型麻风病，病史 2 年，曾接受多种药物治疗。他因疑似红斑结节性麻风病（ENL）而出现皮肤损伤，并接受了口服皮质类固醇治疗。由于试图逐渐减少口服皮质类固醇的剂量导致新的病变出现，因此添加了沙利度胺和环孢素。在使用沙利度胺两个月后，双腿出现深静脉血栓形成（DVT），并开始抗凝治疗，同时未停止使用沙利度胺。DVT 出现后 1 个月发生了肺栓塞，这些血栓栓塞事件被认为是由沙利度胺引起的。本病例强调了在治疗 ENL 时，当同时使用皮质类固醇和沙利度胺时，需要警惕静脉血栓栓塞的风险。
