药物相关性掌跖角化病：系统评价。
Drugs Associated With the Development of Palmoplantar Keratoderma: A Systematic Review.
机构信息
12366 Faculty of Medicine, University of Toronto, Canada.
70384 Faculty of Medicine, University of Western Ontario, London, Canada.
出版信息
J Cutan Med Surg. 2021 Sep;25(5):553-554. doi: 10.1177/12034754211004560. Epub 2021 Mar 28.
BACKGROUND
Palmoplantar keratoderma (PPK) are a heterogenous group of hereditary and acquired disorders that are characterized by excessive epidermal thickening of the palms and/or soles. PPK has been described as a rare adverse event for some medications. The aim of this systematic review was to summarize outcomes in PPK associated with various medications. This data will assist dermatologists and other healthcare providers treating patients with drug-induced PPK.
METHODS
EMBASE and MEDLINE databases were searched in accordance with PRISMA guidelines using the keyword "palmoplantar keratoderma." 40 studies met the inclusion criteria.
RESULTS
A total of 247 patients (mean age: 57.0 years) were included in the analysis. Among patients whose sex was reported, 60.3% ( = 35/58) were male. PPK most frequently developed after treatment with BRAF inhibitors (73.7%, = 182/247), BRAF inhibitors combined with MEK1/2 inhibitors (15.4%, = 38/247), tyrosine kinase inhibitors (TKIs) (3.2%, = 8/247), or chemotherapy (2.4%, = 6/247). The mean latency period between initiation of the drug and onset of PPK was 7.6 months (range: 0.25-90 months). Improvement of PPK was reported in 24 cases, with 50% ( = 12/24) achieving complete resolution and 50% ( = 12/24) achieving partial resolution. All patients who achieved complete resolution stopped the suspected drug, with a mean resolution period of 2.4 months (range: 2 weeks-6 months). The most common treatments for PPK were keratolytic treatments ( = 10) and topical corticosteroids ( = 4).
CONCLUSIONS
PPK was most frequently associated with targeted kinase inhibitors, specifically BRAF, MEK1/2, and tyrosine kinase inhibitors.
背景
掌跖角化病（PPK）是一组遗传性和获得性疾病，其特征是手掌和/或脚底的表皮过度增厚。PPK 已被描述为某些药物的罕见不良反应。本系统评价的目的是总结与各种药物相关的 PPK 的结果。这些数据将有助于治疗药物诱导的 PPK 的皮肤科医生和其他医疗保健提供者。
方法
根据 PRISMA 指南，使用关键字“掌跖角化病”在 EMBASE 和 MEDLINE 数据库中进行搜索。符合纳入标准的有 40 项研究。
结果
共有 247 名患者（平均年龄：57.0 岁）纳入分析。在报告性别患者中，60.3%（=35/58）为男性。PPK 最常发生在接受 BRAF 抑制剂（73.7%，=182/247）、BRAF 抑制剂联合 MEK1/2 抑制剂（15.4%，=38/247）、酪氨酸激酶抑制剂（TKI）（3.2%，=8/247）或化疗（2.4%，=6/247）治疗后。药物开始与 PPK 发作之间的平均潜伏期为 7.6 个月（范围：0.25-90 个月）。24 例报告 PPK 改善，其中 50%（=12/24）完全缓解，50%（=12/24）部分缓解。所有完全缓解的患者均停止使用可疑药物，平均缓解期为 2.4 个月（范围：2 周-6 个月）。PPK 最常用的治疗方法是角质溶解治疗（=10）和外用皮质类固醇（=4）。
结论
PPK 最常与靶向激酶抑制剂相关，特别是 BRAF、MEK1/2 和酪氨酸激酶抑制剂。
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