左旋咪唑治疗顽固性复发性重型多形红斑的疗效：一项观察性研究。

The effect of levamisole in the treatment of recalcitrant recurrent erythema multiforme major: An observational study.

机构信息

Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan; Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Taipei, Linkou and Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.

出版信息

J Dermatol Sci. 2018 Oct;92(1):38-44. doi: 10.1016/j.jdermsci.2018.08.002. Epub 2018 Aug 8.

DOI:10.1016/j.jdermsci.2018.08.002

PMID:30143369

Abstract

BACKGROUND

Erythema multiforme major (EMM) is an immune-mediated mucocutaneous eruption mostly triggered by herpes simplex virus (HSV) infection. A vicious circle of recurrence may be developed due to HSV reactivation and prolonged use of systemic corticosteroids to control EMM. Levamisole is an immunomodulator and has been applied to prevent relapses of recurrent HSV infection.

OBJECTIVE

To evaluate the clinical efficacy and safety of levamisole in patients with recalcitrant recurrent EMM.

METHODS

We enrolled 23 patients with recurrent EMM treated with levamisole and 24 controls, and analyzed the demographics, treatments and outcomes.

RESULTS

Patients with recurrent EMM for years (mean 3.99 ± 2.71) showed significantly reduced recurrences after various durations of levamisole treatment (recurrences after and before treatment: 3.98 ± 1.04 vs 6.75 ± 1.45 times per year, p = 1.33x10). The recurrences of EMM also significantly reduced after levamisole treatment comparing to that of patients without levamisole treatment (p = 3.77x10). No patient was reported to have severe side effects during or after levamisole treatment.

CONCLUSIONS

Levamisole was effective in reducing recurrences of recalcitrant recurrent EMM and can thus be considered an alternative or add-on therapy for this disorder.

摘要

背景

大疱性红斑多形症（EMM）是一种免疫介导的黏膜皮肤发疹，主要由单纯疱疹病毒（HSV）感染引发。由于 HSV 再激活和长期使用全身性皮质类固醇来控制 EMM，可能会形成复发的恶性循环。左旋咪唑是一种免疫调节剂，已被应用于预防复发性 HSV 感染的复发。

目的

评估左旋咪唑在治疗顽固复发性 EMM 患者中的临床疗效和安全性。

方法

我们纳入了 23 例接受左旋咪唑治疗的复发性 EMM 患者和 24 例对照患者，并分析了人口统计学、治疗和结局。

结果

多年（平均 3.99±2.71 年）复发性 EMM 患者在接受不同时长的左旋咪唑治疗后复发明显减少（治疗前后的复发次数：3.98±1.04 次/年与 6.75±1.45 次/年，p=1.33x10）。与未接受左旋咪唑治疗的患者相比，接受左旋咪唑治疗后 EMM 的复发也明显减少（p=3.77x10）。在左旋咪唑治疗期间或之后，没有患者报告有严重的副作用。