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在 SARS-CoV-2(COVID-19)大流行期间治疗皮肤科疾病的全身性免疫生物学、免疫抑制剂和肿瘤药物:快速咨询的快速回顾。

Systemic immunobiological, immunosuppressant, and oncologic agents for the treatment of dermatologic diseases during the SARS-CoV-2 (COVID-19) pandemic emergency: A quick review for a quick consultation.

机构信息

Dermatology Clinic, Sapienza University of Rome, Rome, Italy.

Unit of Dermatology, IRCCS San Raffaele Hospital, Milan, Italy.

出版信息

Dermatol Ther. 2020 Sep;33(5):e13537. doi: 10.1111/dth.13537. Epub 2020 Jun 24.

Abstract

The precision medicine era has helped to better manage patients with immunological and oncological diseases, improving the quality of life of this class of patients. Regarding the management of these patients and positivity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), currently, limited data are available and information is evolving. In this quick review, we have analyzed the mechanisms of action and related infective risk of drugs used for the treatment of immune-mediated and oncologic skin conditions during the daily clinical practice. In general, immunosuppressant and antineoplastic agents for dermatologic treatments do not require suspension and do not require special measures, if not those commonly observed. In the case of a coronavirus disease (COVID-19) patient with complications (such as pneumonia, respiratory failure), treatment suspension should always be considered after taking into account the general condition of the patient, the risk-benefit ratio, and the pathophysiology of COVID-19 infection. The COVID-19 emergency pandemic does not imply undertreatment of existing skin conditions, which together with the SARS-CoV-2 infection may jeopardize the patient's life.

摘要

精准医疗时代有助于更好地管理免疫和肿瘤疾病患者,提高这类患者的生活质量。关于这些患者对严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)的管理,目前,可用的数据有限,信息也在不断发展。在本次快速综述中,我们分析了在日常临床实践中用于治疗免疫介导和肿瘤性皮肤疾病的药物的作用机制和相关感染风险。一般来说,免疫抑制剂和抗肿瘤药物用于皮肤科治疗不需要停药,也不需要特殊措施,除非是通常观察到的措施。对于患有并发症(如肺炎、呼吸衰竭)的冠状病毒病(COVID-19)患者,在考虑患者的一般状况、风险效益比和 COVID-19 感染的病理生理学后,应始终考虑暂停治疗。COVID-19 紧急大流行并不意味着对现有皮肤疾病的治疗不足,这些疾病与 SARS-CoV-2 感染一起可能危及患者的生命。

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