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抗肿瘤坏死因子和免疫调节剂治疗背景下的皮肤T细胞淋巴瘤:一例报告及文献综述

Cutaneous T-cell lymphoma in the setting of anti-tumor necrosis factor and immunomodulator therapy: A case report and literature review.

作者信息

Dotimas James, Das Manjusha, Martin Daniel

机构信息

The University of Illinois College of Medicine at Peoria, Peoria, IL, USA.

Division of Gastroenterology and Hepatology, Department of Internal Medicine, The University of Illinois College of Medicine at Peoria, Peoria, IL, USA.

出版信息

SAGE Open Med Case Rep. 2020 Jun 26;8:2050313X20937223. doi: 10.1177/2050313X20937223. eCollection 2020.

Abstract

Immunosuppressive therapy is well recognized as increasing the risk of lymphoma. Mycosis fungoides is a rare cutaneous form of T-cell lymphoma with a largely unknown etiology and not typically associated with immunosuppression. In this article, we describe our encounter with a 24-year-old male with Crohn's disease in remission on immunotherapy, specifically dual therapy with azathioprine and infliximab, presenting with a facial rash found to be consistent with mycosis fungoides on biopsy. The patient's rash resolved with treatment of topical steroids. In addition, the decision was made to discontinue his azathioprine to minimize his risks of developing future malignancies.

摘要

免疫抑制疗法被公认为会增加患淋巴瘤的风险。蕈样肉芽肿是一种罕见的T细胞淋巴瘤皮肤形式,其病因大多未知,通常与免疫抑制无关。在本文中,我们描述了一名24岁男性克罗恩病患者的情况,该患者在接受免疫疗法(具体为硫唑嘌呤和英夫利昔单抗联合治疗)后病情缓解,出现面部皮疹,活检发现与蕈样肉芽肿一致。患者的皮疹经局部类固醇治疗后消退。此外,决定停用他的硫唑嘌呤,以尽量降低其未来发生恶性肿瘤的风险。

相似文献

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[Mycosis fungoides in a heart transplant recipient].
Ann Dermatol Venereol. 2017 Oct;144(10):624-628. doi: 10.1016/j.annder.2017.05.008. Epub 2017 Jun 23.
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Anti-TNF Monotherapy for Crohn's Disease: a 13-year Multicentre Experience.抗 TNF 单药治疗克罗恩病:13 年多中心经验
J Crohns Colitis. 2016 May;10(5):516-24. doi: 10.1093/ecco-jcc/jjw008. Epub 2016 Jan 22.

本文引用的文献

2
ACG Clinical Guideline: Management of Crohn's Disease in Adults.ACG 临床指南:成人克罗恩病的管理。
Am J Gastroenterol. 2018 Apr;113(4):481-517. doi: 10.1038/ajg.2018.27. Epub 2018 Mar 27.
4
Mycosis Fungoides-like Eruption and Infliximab.
J Clin Gastroenterol. 2016 Aug;50(7):610-1. doi: 10.1097/MCG.0000000000000517.
8
Changing incidence trends of cutaneous T-cell lymphoma.皮肤 T 细胞淋巴瘤发病率变化趋势。
JAMA Dermatol. 2013 Nov;149(11):1295-9. doi: 10.1001/jamadermatol.2013.5526.
10
Crohn's disease.克罗恩病。
Lancet. 2012 Nov 3;380(9853):1590-605. doi: 10.1016/S0140-6736(12)60026-9. Epub 2012 Aug 20.

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