Surjana Devita, Robertson Ivan, Kennedy Glen, James Daniel, Weedon David
Queensland Institute of Dermatology, Greenslopes Private Hospital, Brisbane, Queensland, Australia.
Australas J Dermatol. 2015 Feb;56(1):e21-3. doi: 10.1111/ajd.12108. Epub 2013 Oct 8.
We present a case of cutaneous acute graft-versus-host disease (aGVHD) with confluent erythematous perifollicular hyperkeratosis and ichthyosiform scale in the clinical pattern of type II (atypical adult) pityriasis rubra pilaris (PRP), which developed 26 days after allogeneic peripheral blood stem cell transplant. Skin histology confirmed features of both aGVHD and PRP. The skin lesions were refractory to oral prednisolone and cyclosporine and only partially responsive to a combination of i.v. methylprednisolone, oral tacrolimus, oral mycophenolate mofetil, and infusions of anti-thymocyte globulin and the tumour necrosis factor-α inhibitor, etanercept.
我们报告1例皮肤急性移植物抗宿主病（aGVHD），其临床形态为II型（非典型成人型）毛发红糠疹（PRP），表现为融合性毛囊周围红斑性角化过度及鱼鳞样鳞屑，在异基因外周血干细胞移植后26天出现。皮肤组织学检查证实了aGVHD和PRP的特征。皮肤病变对口服泼尼松龙和环孢素治疗无效，仅对静脉注射甲泼尼龙、口服他克莫司、口服霉酚酸酯以及输注抗胸腺细胞球蛋白和肿瘤坏死因子-α抑制剂依那西普的联合治疗部分有效。
