Dong Huijie, Shen Yingying, Shen Yiping, Wu Dijiong
First Clinical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, People's Republic of China.
Department of Hematology, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310006, People's Republic of China.
Int J Gen Med. 2020 Nov 19;13:1187-1192. doi: 10.2147/IJGM.S281476. eCollection 2020.
A 49-year-old male patient who had been diagnosed with variable hairy cell leukemia (HCL-V) was treated with interferon for half a year but exert no obvious effect. After two courses of chemotherapy with cladribine, he achieved remission, and splenomegaly significantly improved (the length in craniocaudal dimension decreased from 15.8cm to 11.8cm). Four years later, the patient got disease relapse and was recommended for another cycle of cladribine (6mg for 7 days). On the last day of cladribine, the patient developed fever with needle-like red rashes on the face, limbs, and trunk. At the very beginning, the rash was lighter in color, sparsely distributed, and without obvious itching. Three days later, the rash gradually darkened, expanded and merged, with itching. With the application of high dose gamma globulin and corticosteroids (prednisolone combined with dexamethasone), the rash finally faded, and the patient was discharged. Rash caused by cladribine is not uncommon, such serious and widespread drug-induced rash is rare, and there are few reports. This article reviewed relevant studies and treatments.
一名49岁男性患者，被诊断为变异型毛细胞白血病（HCL-V），接受干扰素治疗半年但效果不明显。接受两疗程克拉屈滨化疗后，病情缓解，脾肿大明显改善（头尾径长度从15.8cm降至11.8cm）。四年后，患者疾病复发，建议再次进行一疗程克拉屈滨治疗（6mg，持续7天）。在克拉屈滨治疗的最后一天，患者出现发热，面部、四肢及躯干出现针状红色皮疹。起初，皮疹颜色较浅，分布稀疏，无明显瘙痒。三天后，皮疹逐渐变暗、扩大并融合，伴有瘙痒。经应用大剂量丙种球蛋白和糖皮质激素（泼尼松联合地塞米松）治疗后，皮疹最终消退，患者出院。克拉屈滨引起的皮疹并不少见，但如此严重且广泛的药物性皮疹较为罕见，相关报道较少。本文对相关研究及治疗进行了综述。
