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成功用粒细胞和单核细胞吸附清除术治疗坏疽性脓皮病。

Successful treatment of pyoderma gangrenosum with granulocyte and monocyte adsorption apheresis.

机构信息

Unit of Dermatology, University of Padua, Padua, Italy.

Apheresis Unit, University of Padua, Padua, Italy.

出版信息

Int Wound J. 2017 Feb;14(1):282-284. doi: 10.1111/iwj.12684. Epub 2016 Oct 28.

Abstract

Pyoderma gangrenosum is a neutrophilic dermatosis clinically characterised by the presence of painful skin ulcerations with erythematous and undetermined borders and histologically by the presence of neutrophilic infiltrates in the dermis. Granulocyte and monocyte adsorption apheresis, also called granulocytapheresis, is a therapeutic strategy for extracorporeal immunomodulation that selectively removes activated granulocytes and monocytes/macrophages from the peripheral blood. Here, we report a case of a 73-year-old patient affected by a severe form of pyoderma gangrenosum presenting with multiple painful ulcers and pustules on his trunk and extremities. The disease was resistant to high doses of methylprednisolone and methotrexate and successfully treated by granulocyte and monocyte adsorption apheresis. To the best of our knowledge, this is the first report on the efficacy of granulocyte and monocyte adsorption apheresis in pyoderma gangrenosum in Europe.

摘要

坏疽性脓皮病是一种中性粒细胞皮肤病,临床上表现为疼痛性皮肤溃疡,边界呈红斑状且不确定,组织学上表现为真皮中有中性粒细胞浸润。粒细胞单核细胞吸附清除术,也称为粒细胞清除术,是一种用于体外免疫调节的治疗策略,可选择性地从外周血中去除活化的粒细胞和单核细胞/巨噬细胞。在这里,我们报告了一例 73 岁患者的病例,该患者患有严重的坏疽性脓皮病,其躯干和四肢上有多个疼痛性溃疡和脓疱。该疾病对大剂量甲基强的松龙和甲氨蝶呤治疗有抗性,并通过粒细胞单核细胞吸附清除术成功治疗。据我们所知,这是欧洲首例关于粒细胞单核细胞吸附清除术治疗坏疽性脓皮病疗效的报告。

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本文引用的文献

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A Case of Old Age-Onset Generalized Pustular Psoriasis with a Deficiency of IL-36RN (DITRA) Treated by Granulocyte and Monocyte Apheresis.
Case Rep Dermatol. 2015 Feb 21;7(1):29-35. doi: 10.1159/000380876. eCollection 2015 Jan-Apr.
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