Department of Neurology, University of Würzburg, Josef-Schneider-Straße 11, 97080 Würzburg, Germany.
J Clin Neurosci. 2012 Sep;19(9):1312-3. doi: 10.1016/j.jocn.2011.11.026. Epub 2012 Jun 20.
Multiple sclerosis (MS) patients may experience severe local inflammatory skin reactions during disease-modifying therapy with subcutaneously injected interferon-β (IFN-β). It is common clinical practice to switch those patients to an intramuscularly administered formulation, where severe local skin reactions have not been described. Here we report a 42-year-old woman with stable relapsing-remitting MS, who was switched from subcutaneously to intramuscularly injected IFN-β1a due to abdominal skin necroses and slight multifocal lipoatrophy. After two years of complication-free therapy with intramuscular IFN-β1a, the patient slowly developed painful lobular panniculitis and severe lipoatrophy of both lateral thighs. A careful diagnostic workup identified misguided subcutaneous injections due to a wrong injection angle as the most plausible cause. Upon correction of her injection technique, pain and skin reddening resolved, while her disfiguring lipoatrophy was irreversible. This report should enhance awareness that severe skin adverse effects may also occur, although rarely, with IFN-β for intramuscular injection. Early recognition and correction of the injection technique may help to prevent severe complications.
多发性硬化症（MS）患者在接受皮下注射干扰素-β（IFN-β）的治疗时，可能会出现严重的局部炎症性皮肤反应。因此，临床上通常会将这些患者转为肌肉内注射剂型，因为尚未描述过这种剂型会出现严重的局部皮肤反应。在此，我们报告了一位 42 岁的女性，她患有稳定的复发缓解型多发性硬化症，由于腹部皮肤坏死和轻度多灶性脂肪萎缩，她从皮下注射转为肌肉内注射 IFN-β1a。在接受肌肉内 IFN-β1a 两年无并发症的治疗后，患者逐渐出现疼痛性小叶性脂膜炎和双侧大腿外侧严重的脂肪萎缩。经过仔细的诊断评估，发现由于注射角度错误导致皮下注射位置不当是最可能的原因。纠正注射技术后，疼痛和皮肤发红得到缓解，而她的畸形脂肪萎缩则是不可逆的。本报告应提高人们的认识，即严重的皮肤不良反应也可能发生，尽管很少见，但也可能与肌肉内注射 IFN-β 有关。早期识别和纠正注射技术可能有助于预防严重的并发症。
