贝赫切特病患者使用英夫利昔单抗后引发银屑病。
Psoriasis triggered by infliximab in a patient with Behçet's disease.
机构信息
Department of Ophthalmology, Tokyo Medical and Dental University Graduate School of Medicine and Dental Sciences, Tokyo, Japan.
出版信息
Jpn J Ophthalmol. 2013 Jan;57(1):95-7. doi: 10.1007/s10384-012-0198-4. Epub 2012 Oct 23.
PURPOSE
To report a case of psoriasis triggered by anti-tumor necrosis factor-alpha (TNF-α) therapy in a uveitis patient with Behçet's disease.
CASE REPORT
A 34-year-old man with established Behçet's disease was started on infliximab therapy for recurrent uveitis and showed an excellent response. After 2 years of infliximab treatment, he developed erythematous scaly plaques on both of his palms and heels. No clinical or serological evidence of infection was found, and there was no personal/family history of psoriasis. Histological examination of one lesion showed that it was consistent with psoriasis. Because of the development of hyperkeratotic skin lesions consistent with guttate psoriasis, the infliximab treatment was discontinued. Six months later, the psoriasis had resolved.
CONCLUSIONS
Blockade of TNF-α is an effective treatment for psoriasis as well as Behçet's disease. However, we have to consider new-onset psoriasis as an adverse side effect that can be triggered by anti-TNF-α therapy in Behçet's disease.
目的
报告一例因抗肿瘤坏死因子-α（TNF-α）治疗而引发的贝切特病伴葡萄膜炎患者的银屑病病例。
病例报告
一名 34 岁男性患有明确的贝切特病，因复发性葡萄膜炎开始接受英夫利昔单抗治疗，治疗效果极佳。英夫利昔单抗治疗 2 年后，他的双掌和足跟出现红斑鳞屑性斑块。未发现感染的临床或血清学证据，且无银屑病个人/家族史。一个皮损的组织学检查结果显示其符合银屑病。由于出现符合点滴状银屑病的角化过度性皮肤病变，停止使用英夫利昔单抗治疗。6 个月后，银屑病已消退。
结论
TNF-α 阻断剂是治疗银屑病和贝切特病的有效方法。然而，我们必须考虑到在贝切特病患者中，抗 TNF-α 治疗可能引发新发银屑病这一不良反应。
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