Ziółkowska Ewa, Biedka Marta, Zyromska Agnieszka, Makarewicz Roman
Radiotherapy Department I, Oncology Centre in Bydgoszcz, Romanowskiej 2 St., 85-796 Bydgoszcz, Poland.
Radiotherapy Department I, Oncology Centre in Bydgoszcz, Romanowskiej 2 St., 85-796 Bydgoszcz, Poland ; Chair and Clinic of Oncology and Brachytherapy, Nicolaus Copernicus University in Toruń, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Poland.
Rep Pract Oncol Radiother. 2010 Jul 6;15(4):103-6. doi: 10.1016/j.rpor.2010.03.003. eCollection 2010.
Psoriasis, as the most common inflammatory skin disorder, affects about 2-3% of the world's population. Many non-dermatological conditions have been linked with psoriasis, including cardiovascular diseases, depression, inflammatory bowel disorders, and some cancers, i.e. lung, colon and kidney cancers. Among systemic factors are endocrine and metabolic disturbances as well as many drugs. Erythrodermic psoriasis, the most severe form of the disease, is characterized by diffuse erytrema and scaling, often accompanied by fever, chills, and malaise. A 57-year-old Caucasian man was admitted for curative radiation therapy of adenocarcinoma of the prostate after 3 months of initial hormonal therapy. The management comprised the combined androgen blockade (CAB). On admission the patient reported escalation of psoriasis symptoms, which he had been treated for since 2002. Due to a mild course of the disease he had not required any systemic treatment ever before, even during aggravation periods. The last exacerbation started appearing a month after hormonal therapy implementation. The cutaneous eruptions, already existing, become larger with new foci revealing, mainly on upper and lower limbs. During radiotherapy planning, there appeared a diffuse erythema and scaling on hands and feet with accompanying pruritis. We decided to start the previously planned radiation therapy which included the prostate gland with 1.5 cm margin and provided for the total dose of 72 Gy in 36 fractions. The irradiation was conducted with the four-field technique using a megavoltage linear accelerator. During radiotherapy we photo-documented skin lesions. To our best knowledge hormone therapy (androgen deprivation) of prostate cancer patients has not been reported as an aggravating factor. Thus, the aim of our work is to present the case of a prostate cancer patient who experienced psoriasis exacerbation after implementation of hormonal blockade as a neoadjuvant oncological treatment.
银屑病是最常见的炎症性皮肤病，影响着全球约2%-3%的人口。许多非皮肤病学病症都与银屑病有关，包括心血管疾病、抑郁症、炎症性肠病以及一些癌症，如肺癌、结肠癌和肾癌。全身因素包括内分泌和代谢紊乱以及许多药物。红皮病型银屑病是该病最严重的形式，其特征为弥漫性红斑和鳞屑，常伴有发热、寒战和不适。一名57岁的白种男性在接受了3个月的初始激素治疗后，因前列腺腺癌接受根治性放射治疗入院。治疗方案包括联合雄激素阻断（CAB）。入院时，患者报告银屑病症状加重，自2002年以来他一直在接受治疗。由于病情较轻，他以前从未需要过任何全身治疗，即使在病情加重期间也是如此。上一次病情加重在激素治疗开始后一个月出现。已有的皮肤疹块变大，出现新的病灶，主要集中在上下肢。在放疗计划期间，手脚出现弥漫性红斑和鳞屑，并伴有瘙痒。我们决定开始之前计划的放射治疗，该治疗包括对前列腺及其边缘1.5厘米范围进行照射，总剂量为72 Gy，分36次进行。使用兆伏级直线加速器通过四野技术进行照射。在放疗期间，我们对皮肤病变进行了拍照记录。据我们所知，尚未有报道称前列腺癌患者的激素治疗（雄激素剥夺）是病情加重的因素。因此，我们此项工作的目的是介绍一例前列腺癌患者在实施激素阻断作为新辅助肿瘤治疗后银屑病病情加重的病例。
