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[一名多药致敏患者伴非典型出血性皮肤病变诊断为毛细胞白血病]

[Hairy cell leukaemia diagnosed in a polysensitized patient with atypical haemorrhagic skin lesions].

作者信息

Fábián Melinda, Pónyai Györgyi, Szombath Gergely, Nagy Eszter, Komlósi Zsolt, Szigeti Ágnes, Lőrincz Kende, Hidvégi Bernadett, Medvecz Márta

机构信息

Általános Orvostudományi Kar, Bőr-, Nemikórtani és Bőronkológiai Klinika,Semmelweis Egyetem, Budapest, Mária u. 41., 1085.

Általános Orvostudományi Kar, Belgyógyászati és Hematológiai Klinika,Semmelweis Egyetem, Budapest.

出版信息

Orv Hetil. 2020 Sep;161(38):1646-1651. doi: 10.1556/650.2020.31831.

Abstract

As the topical use of non-steroidal anti-inflammatory drugs (NSAIDs) has gained popularity recently, adverse reactions related to their application have also become more common. The authors present the case of a 49-year-old man, who used etofenamate gel to treat leg pain. Following sun exposure, haemorrhagic, atypical lesions appeared and after rapid spread of the symptoms, the patient was hospitalized. In the area of the etofenamate application as well as on both legs, arms, trunk and face, confluent, erythematous sero-papules and macules were found, along with petechiae on the oral mucosa. Splenomegaly and thrombocytopenia accompanied the skin symptoms, which prompted an oncohematological workup, and the patient was diagnosed with hairy cell leukaemia. Epicutaneous testing (ET) was performed and found a positive reaction to etofenamate gel as well wood tar, propylen glycol, fragrance mix I, methylisothiazolinone, benzoic acid and balsam of Peru. The lymphocyte transformation test (LTT) and CD69 expression were negative for etofenamate. Orv Hetil. 2020; 161(38): 1646-1651.

摘要

随着非甾体抗炎药(NSAIDs)局部用药近来日益普遍,与其应用相关的不良反应也变得更为常见。作者报告了一例49岁男性病例,该患者使用依托芬那酯凝胶治疗腿部疼痛。日晒后,出现了出血性非典型皮损,症状迅速蔓延后患者住院。在依托芬那酯用药部位以及双腿、双臂、躯干和面部,发现有融合性红斑性血清丘疹和斑疹,同时口腔黏膜有瘀点。皮肤症状伴有脾肿大和血小板减少,这促使进行肿瘤血液学检查,患者被诊断为毛细胞白血病。进行了皮肤试验(ET),发现对依托芬那酯凝胶以及木焦油、丙二醇、香料混合物I、甲基异噻唑啉酮、苯甲酸和秘鲁香脂呈阳性反应。依托芬那酯的淋巴细胞转化试验(LTT)和CD69表达为阴性。《匈牙利医学周报》。2020年;161(38): 1646 - 1651。

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