Wilson D J, Kay V, Charig M, Hughes D G, Creasy T S
Department of Radiology, John Radcliffe Hospital, Oxford, U.K.
Br J Dermatol. 1988 Nov;119(5):597-607. doi: 10.1111/j.1365-2133.1988.tb03470.x.
In an ongoing study of patients on long-term etretinate (Tigason) therapy, 13 patients with a congenital or inherited disorder of keratinization and 10 patients with psoriasis were examined to investigate the incidence of, and the factors associated with, skeletal hyperostosis. Skeletal scintigraphy, plain radiographs, haematological and biochemical analyses were performed. Using all criteria, 7 of 13 patients with a congenital or inherited disorder of keratinization showed evidence of hyperostosis. No single investigation was able to detect all these cases; in particular, skeletal scintigraphy was positive in only nine of the 13 patients who showed hyperostosis. Eleven of the 13 patients with hyperostosis gave a history of musculoskeletal symptoms compared with three of the 10 patients without hyperostosis. There was no clear association with total dose or duration of treatment. Serum chemistry and haematological studies were normal. In two patients the 24-h urinary calcium excretion was significantly elevated, an abnormality which has not been described previously. Annual lateral thoracic spine radiographs with additional views of symptomatic areas are recommended for patients on long-term etretinate therapy.
在一项针对长期服用依曲替酯（银屑灵）治疗患者的正在进行的研究中，对13例先天性或遗传性角化异常患者和10例银屑病患者进行了检查，以调查骨骼骨质增生的发生率及其相关因素。进行了骨骼闪烁扫描、X线平片、血液学和生化分析。根据所有标准，13例先天性或遗传性角化异常患者中有7例显示有骨质增生的证据。没有任何一项检查能够检测出所有这些病例；特别是，骨骼闪烁扫描在显示骨质增生的13例患者中仅有9例呈阳性。13例骨质增生患者中有11例有肌肉骨骼症状史，而10例无骨质增生患者中有3例有此症状史。与治疗的总剂量或疗程没有明显关联。血清化学和血液学研究均正常。2例患者24小时尿钙排泄显著升高，这一异常情况此前未曾有过描述。对于长期服用依曲替酯治疗的患者，建议每年拍摄胸椎侧位X线片，并对有症状的部位进行额外检查。
