Santos Julia Rocha Silva, Vendramini Dâmia Leal, Nery José Augusto da Costa, Avelleira João Carlos Regazzi
Professor Rubem David Azulay Dermatology Institute, Santa Casa de Misericórdia do Rio de Janeiro (DPRDA-SCMRJ) - Rio de Janeiro (RJ), Brazil.
Leprosy Laboratory, Fundação Oswaldo Cruz, Fiocruz - Rio de Janeiro (RJ), Brazil.
An Bras Dermatol. 2017 Jul-Aug;92(4):575-577. doi: 10.1590/abd1806-4841.20175471.
One of the biggest challenges in treating leprosy is the control of reaction events. Patients with lepromatous leprosy may present reaction type II, or erythema nodosum leprosum, during treatment, and this reaction can remain in a recurrent form after being released from the hospital, requiring the use of thalidomide and/or prednisone for long periods of time, in turn increasing the risk of side effects. Two reports of the use of antiTNF to treat erythema nodosum leprosum were found in the literature. A good response was found after an assay with infliximab and etanercept. This study reports on a patient with lepromatous leprosy and recurrent reaction, controlled by using etanercept and a 10-month follow-up, with the interruption of thalidomide and the maintenance of prednisone at 10 mg/day.
治疗麻风病最大的挑战之一是控制反应性事件。瘤型麻风患者在治疗期间可能出现Ⅱ型反应,即麻风结节性红斑,并且这种反应在出院后可能会反复出现,需要长期使用沙利度胺和/或泼尼松,这反过来又增加了副作用的风险。文献中发现了两篇关于使用抗TNF治疗麻风结节性红斑的报告。使用英夫利昔单抗和依那西普进行检测后发现有良好反应。本研究报告了一名瘤型麻风反复反应患者,通过使用依那西普进行控制,并进行了10个月的随访,停用了沙利度胺,维持泼尼松剂量为每日10毫克。