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抗白细胞介素-17 治疗过程中出现的湿疹样发疹的临床和组织病理学特征:病例系列和文献复习。

Clinical and histopathological characterization of eczematous eruptions occurring in course of anti IL-17 treatment: a case series and review of the literature.

机构信息

Institute of Dermatology, Università Cattolica del Sacro Cuore, Rome, Italy.

Department of Dermatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

出版信息

Expert Opin Biol Ther. 2020 Jun;20(6):665-672. doi: 10.1080/14712598.2020.1727439. Epub 2020 Feb 17.

Abstract

: Real-life data often highlight the side effects of certain drugs not previously reported in randomized controlled trials (RCTs). To describe cutaneous inflammatory eruptions in psoriatic patients treated with an anti IL-17A agent (secukinumab or ixekizumab).: Retrospective analysis of a cohort of patients with chronic plaque psoriasis who started an anti IL-17A agent between September 2016-February 2019 and who developed cutaneous inflammatory eruptions during treatment. A systematic review of similar events reported in the literature was performed.: Data of 468 patients were reviewed and 27 cutaneous inflammatory eruptions of 27 (5.8%) patients were collected. The eruptions appeared after a mean of 16.9 ± 17.0 weeks of therapy showing a classical acute eczema in 11 patients (40.7%), an atopic dermatitis-like rash in 11 patients (40.7%) and a psoriasiform eruption in 5 patients (18.5%). Histopathology of 12/27 cases showed epidermal spongiosis in all these variants.: We described the clinic-pathologic features of some eczematous eruptions occurring in psoriatic patients, 3-4 months after treatment initiation with an anti IL-17A agent. Further investigations are needed to explain this phenomenon, that might be defined a paradoxical adverse event, based upon the role of IL17 in eczema pathogenesis.

摘要

: 真实世界的数据经常强调某些药物的副作用,这些副作用以前在随机对照试验(RCT)中没有报道过。描述接受抗 IL-17A 药物(司库奇尤单抗或依奇珠单抗)治疗的银屑病患者出现的皮肤炎症性发疹。: 对 2016 年 9 月至 2019 年 2 月期间开始使用抗 IL-17A 药物的慢性斑块型银屑病患者队列进行回顾性分析,这些患者在治疗过程中出现皮肤炎症性发疹。对文献中报告的类似事件进行了系统回顾。: 共回顾了 468 例患者的数据,共收集了 27 例(5.8%)患者的 27 例皮肤炎症性发疹。这些发疹出现在治疗后平均 16.9±17.0 周,11 例(40.7%)表现为典型急性湿疹,11 例(40.7%)表现为特应性皮炎样皮疹,5 例(18.5%)表现为银屑病样发疹。27 例中的 12 例进行了组织病理学检查,所有这些变异型均显示表皮海绵形成。: 我们描述了在开始使用抗 IL-17A 药物治疗 3-4 个月后,银屑病患者出现的一些湿疹性发疹的临床病理特征。需要进一步研究来解释这种现象,根据 IL17 在湿疹发病机制中的作用,这种现象可能被定义为一种矛盾的不良反应。

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