Pinto J S, Sobrinho L, da Silva M B, Porto M T, Santos M A, Baló-Banga M, Arala-Chaves M
Department of Dermatology, Faculty of Medical Sciences, Portuguese Cancer Institute, Lisbon.
Dermatologica. 1990;180(3):146-50.
We report a case of a 23-year-old woman who was afflicted with disseminated skin erythema multiforme-like eruptions that started at the menarche, relapsed at the premenstrual periods, dramatically spread during two pregnancies and cleared after abortion; the skin lesions responded dramatically to thalidomide treatment. A high-affinity binding factor to 17 alpha-hydroxyprogesterone (17-OHP) was found in the serum of this patient. Her lymphocytes did not proliferate in vitro after exposure to exogenous 17-OHP but showed significant chromatin activation. There was a decreased expression of HLA antigens at the surface of the patient's blood lymphocytes. This is a unique well-documented case of erythema multiforme most possibly due to autoreactivity to 17-OHP; the precise mechanism(s) of this autoreactivity has not been established.
我们报告了一例23岁女性病例，该患者患有播散性多形红斑样皮疹，自月经初潮起病，在月经前期复发，在两次怀孕期间皮疹显著扩散，流产后皮疹消退；皮肤病变对沙利度胺治疗反应显著。在该患者血清中发现了一种与17α-羟孕酮（17-OHP）具有高亲和力的结合因子。该患者的淋巴细胞在体外暴露于外源性17-OHP后未增殖，但显示出明显的染色质激活。患者血液淋巴细胞表面的HLA抗原表达降低。这是一例记录详实的独特多形红斑病例，极有可能是由于对17-OHP的自身反应性所致；这种自身反应性的确切机制尚未明确。
