Courties Alice, Guégan Sarah, Miquel Anne, Duriez Paul, Berenbaum Francis, Sellam Jérémie
Service de rhumatologie, université Paris 06, hôpital Saint-Antoine, AP-HP, DHU « inflammation, immunopathologie, biothérapie » I2B, Paris, France.
Service de dermatologie, université Paris 06, hôpital Tenon, AP-HP, Paris, France.
Joint Bone Spine. 2014 Mar;81(2):178-9. doi: 10.1016/j.jbspin.2013.06.012. Epub 2013 Oct 7.
Fibroblastic rheumatism is a very rare cause of distal and bilateral polyarthritis characterized by cutaneous nodules, sclerodactylitis, thickened palmar fascia and Raynaud phenomenon. Physiopathology remains unknown and the diagnosis is histologic. Despite the use of immunosuppressive agents in some isolated cases with a variable efficacy, we report a case of typical fibroblastic rheumatism with severe digital retraction who dramatically improved after intensive physical therapy without immunosuppressive drugs prescription. Such a case illustrates that improvement may be spontaneous and that non pharmacological approach is a cornerstone in the management of this disease.
纤维母细胞性风湿病是远端和双侧多关节炎的一种非常罕见的病因，其特征为皮肤结节、指（趾）硬皮病、掌腱膜增厚和雷诺现象。其病理生理学仍不清楚，诊断依靠组织学检查。尽管在一些个别病例中使用了免疫抑制剂，疗效不一，但我们报告了一例典型的纤维母细胞性风湿病患者，该患者有严重的手指挛缩，在未开具免疫抑制药物的情况下，经过强化物理治疗后病情显著改善。这样一个病例表明，病情改善可能是自发的，非药物治疗方法是这种疾病管理的基石。
