From the University of Texas Southwestern Medical Center, Dallas.
Dermatitis. 2018 Sep/Oct;29(5):282-284. doi: 10.1097/DER.0000000000000409.
Allergic contact dermatitis to metals has become increasingly recognized in patients with endovascular implants. The ACD can lead to in-stent restenosis as well as a prominent eczematous reaction overlying the implant, often necessitating its removal. We present a case of refractory allergic contact dermatitis to nickel in a 44-year-old man with numerous endovascular stents and vascular clips. He developed numerous adverse effects of systemic therapy to manage his symptoms including recurrent infections leading to frequent hospitalizations. He was effectively transitioned to dupilumab, a monoclonal antibody against the IL-4α subunit currently approved by the Food and Drug Administration in the management of atopic dermatitis, with an improvement in symptoms and a reduction in infection rate.
金属过敏性接触性皮炎在接受血管内植入物治疗的患者中越来越受到关注。这种接触性皮炎会导致支架内再狭窄，以及在植入物上出现明显的湿疹样反应，通常需要将其移除。我们报告了一例 44 岁男性的镍过敏接触性皮炎，该患者有许多血管内支架和血管夹。他因全身治疗出现了许多不良反应，包括反复感染导致频繁住院。他成功地转为使用度普利尤单抗（一种针对白细胞介素-4α亚单位的单克隆抗体），该药目前已获得美国食品和药物管理局批准用于治疗特应性皮炎，他的症状得到了改善，感染率也降低了。
