Nakayama Chihiro, Fujita Yasuyuki, Watanabe Mika, Shimizu Hiroshi
Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
J Dermatol. 2015 Oct;42(10):996-8. doi: 10.1111/1346-8138.12943. Epub 2015 May 25.
Ustekinumab is a human monoclonal antibody that specifically binds to the p40 subunit of interleukin (IL)-12 and IL-23, inhibiting the activity of both cytokines, thereby blocking the T-helper (Th)1 and Th17 inflammatory pathways. While biologic agents have dramatically changed the strategies of psoriasis treatment, increasing cases of autoimmune diseases during the use of such agents have been reported. We experienced a case of bullous pemphigoid occurring during treatment of a rare variant of psoriatic arthritis, psoriatic onycho-pachydermo periostitis with ustekinumab. Only six cases of autoimmune blistering diseases during treatment with biologic agents have ever been reported including our case, and we herein review the published work of these cases. Dermatologists must be attentive to the possibility of autoimmune blistering diseases during ustekinumab treatment.
优特克单抗是一种人源单克隆抗体，它能特异性结合白细胞介素（IL）-12和IL-23的p40亚基，抑制这两种细胞因子的活性，从而阻断辅助性T（Th）1和Th17炎症通路。虽然生物制剂极大地改变了银屑病的治疗策略，但使用这类制剂期间自身免疫性疾病病例增多的情况已有报道。我们遇到了1例在用优特克单抗治疗银屑病关节炎的罕见变异型——银屑病性甲厚皮性骨膜炎时发生大疱性类天疱疮的病例。包括我们的病例在内，此前仅有6例在用生物制剂治疗期间发生自身免疫性水疱病的病例报道，我们在此回顾这些病例的已发表文献。皮肤科医生在优特克单抗治疗期间必须留意自身免疫性水疱病的可能性。
