Kushi Jonathan, Csuka M E
Department of Rheumatology, Medical College of Wisconsin, FEC 4764, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, USA.
Case Rep Rheumatol. 2011;2011:951948. doi: 10.1155/2011/951948. Epub 2011 Nov 3.
We present a case of a 69-year-old woman who received external beam radiation for the treatment of breast cancer. Seven months later, she developed generalized morphea involving the area of irradiated skin of the breast as well as distant sites of the groin and distal lower extremity. Postirradiation morphea is an uncommon yet well-documented phenomenon, usually confined to the radiated site and the immediate surrounding tissue. To our knowledge, this is only the fourth reported case of morphea occurring distant from the radiation field. While most cases of postirradiation morphea have been shown to either resolve spontaneously or respond to topical corticosteroids, our patient required systemic therapy with methotrexate, which resulted in clinical improvement. With this paper, we hope to bring further awareness to this phenomenon and demonstrate a successful treatment response with the use of methotrexate in postirradiation generalized morphea.
我们报告一例69岁女性，她接受了外照射放疗以治疗乳腺癌。七个月后，她出现了泛发性硬斑病，累及乳房放疗部位以及腹股沟和下肢远端等远处部位。放疗后硬斑病是一种罕见但有充分文献记载的现象，通常局限于放疗部位及紧邻的周围组织。据我们所知，这是第四例报道的硬斑病发生在远离放疗野部位的病例。虽然大多数放疗后硬斑病病例已显示可自发缓解或对局部糖皮质激素有反应，但我们的患者需要甲氨蝶呤全身治疗，治疗后临床症状有所改善。通过本文，我们希望提高对这一现象的进一步认识，并展示甲氨蝶呤在放疗后泛发性硬斑病治疗中的成功疗效。
