Garber Caren, Rosmarin David, Nguyen Bichchau, Goodarzi Mahmoud, Shinagare Shweta, Jessup Chad, Madani Abdulaziz, Au Shiu-Chung, Hasanain Afnan
Department of Dermatology, Tufts Medical Center, Boston, MA Tufts University School of Medicine, Boston, MA.
Dermatol Online J. 2017 Mar 15;23(3):13030/qt2s2128vw.
Discrete papular lichen myxedematosus (DPLM), asubset of localized lichen myxedematosus, is a rarecutaneous mucinosis of unknown etiology. We reporta case of a 57-year-old woman with palmoplantarpsoriasis who developed DPLM 8 weeks after addingustekinumab to a long-term course of methotrexate.The patient had previously failed 2 prior tumor necrosisfactor (TNF) inhibitors, adalimumab and etanercept.This case demonstrates an association between TNFinhibitor and ustekinumab use in a psoriasis patientand localized lichen myxedematosus for the secondtime in the literature. The presented case is of interestbecause of the rare diagnosis of DPLM, especially inassociation with the start of the anti-IL 12/23 agentustekinumab. The appearance of DPLM in this settingsuggests a possible etiology for the disease.
离散性丘疹性黏液性苔藓（DPLM）是局限性黏液性苔藓的一个亚型，是一种病因不明的罕见皮肤黏蛋白沉积症。我们报告一例57岁患有掌跖银屑病的女性病例，该患者在甲氨蝶呤长期治疗过程中加用乌司奴单抗8周后发生了DPLM。该患者之前使用两种肿瘤坏死因子（TNF）抑制剂阿达木单抗和依那西普均治疗失败。该病例在文献中第二次证明了银屑病患者使用TNF抑制剂和乌司奴单抗与局限性黏液性苔藓之间存在关联。本病例值得关注，因为DPLM诊断罕见，尤其是与抗IL-12/23药物乌司奴单抗的起始使用相关。在这种情况下DPLM的出现提示了该疾病可能的病因。
