Department of Dermatology, University College London Hospital, London, UK.
Dermatol Ther. 2013 Jul-Aug;26(4):370-2. doi: 10.1111/dth.12002. Epub 2013 Apr 12.
Two patients with a long-standing history of recalcitrant ankylosing spondylitis were commenced on adalimumab as monotherapy. Case 1 developed marked rapid deterioration in his previously stable vitiligo within 3 months of commencing treatment. This was attributed to anti-tumor necrosis factor (TNF) therapy, and a marked improvement was noted following withdrawal of adalimumab. Case 2 developed multiple new halo naevi over the trunk and limbs. They did not show dysplastic features and have remained unchanged despite continuation of treatment. Possible mechanisms and implications of the paradoxical occurrence of immune-mediated skin lesions seen in patients receiving anti-TNF therapies are discussed.
两名患有长期难治性强直性脊柱炎的患者开始接受阿达木单抗单药治疗。病例 1 在开始治疗后 3 个月内，其先前稳定的白癜风出现明显迅速恶化。这归因于抗肿瘤坏死因子（TNF）治疗，停用阿达木单抗后明显改善。病例 2 在躯干和四肢出现多个新的晕痣。它们没有显示出发育不良的特征，并且尽管继续治疗，但仍保持不变。讨论了接受抗 TNF 治疗的患者中出现的免疫介导的皮肤病变的这种矛盾发生的可能机制和意义。
