Stieger Marco, Schmid Jean-Paul, Yawalkar Nikhil, Hunziker Thomas
Department of Dermatology, Bern University Hospital and University of Bern, Bern, Switzerland.
Dermatology. 2015;230(1):82-6. doi: 10.1159/000368351. Epub 2014 Dec 5.
Painful cutaneous injection site reactions may hamper treatment with interferon β (IFN-β) and glatiramer acetate (GA) in multiple sclerosis (MS) patients.
To maintain therapy adherence, efficient therapeutic modalities for these subcutaneous inflammatory lesions are urgently needed. We tested the application of local extracorporeal shock wave therapy (ESWT).
We applied 5 sessions of ESWT to 8 patients suffering from MS who had developed painful panniculitis at the injection sites of either IFN-β or GA. Clinical outcomes, i.e. pain reduction and regression of induration, were assessed 3 and 6 months after completion of the ESWT using a visual analogue score.
All patients showed both significant pain reduction and reduction of the skin induration in the treated lesions, while in untreated control lesions there was no improvement.
ESWT proved to be a non-invasive, safe and efficient physical treatment modality for injection-induced painful cutaneous side effects of disease-modifying drugs in MS.
在多发性硬化症（MS）患者中，疼痛性皮肤注射部位反应可能会妨碍使用β-干扰素（IFN-β）和醋酸格拉替雷（GA）进行治疗。
为了维持治疗依从性，迫切需要针对这些皮下炎性病变的有效治疗方法。我们测试了局部体外冲击波疗法（ESWT）的应用。
我们对8例在IFN-β或GA注射部位发生疼痛性脂膜炎的MS患者应用了5次ESWT。在ESWT完成后3个月和6个月，使用视觉模拟评分评估临床结果，即疼痛减轻和硬结消退情况。
所有患者治疗部位的疼痛均显著减轻，皮肤硬结也有所减轻，而未治疗的对照部位则无改善。
对于MS患者中疾病修饰药物注射引起的疼痛性皮肤副作用，ESWT被证明是一种无创、安全且有效的物理治疗方法。
