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COVID-19 大流行期间,光化学疗法成功治疗一例银屑病。

A case of psoriasis successfully treated by extracorporeal photopheresis during COVID-19 pandemic.

机构信息

Departments of Dermatology and Venereology, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey.

Departments of Hematology, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey.

出版信息

Transfus Apher Sci. 2021 Oct;60(5):103200. doi: 10.1016/j.transci.2021.103200. Epub 2021 Jun 26.

Abstract

Psoriasis is a chronic inflammatory skin disease that is characterized by well-demarcated erythematous plaques with a silver scale. Although many new and emerging therapeutic agents are often sufficient to control the disease, there is still a need for alternative treatment options in challenging cases. Extracorporeal photopheresis (ECP) has been applied to many T-cell-mediated diseases to restore immune homeostasis and treat psoriasis effectively. In this paper, we present a psoriasis patient who did not respond to methotrexate, narrowband ultraviolet B, or acitretin. Because of a diagnosis of non-Hodgkin lymphoma, the patient had contraindications for cyclosporine, fumaric acid esters, and biologics but achieved remission with a total of 12 sessions of ECP in two and a half months. Although exacerbation was recorded after polymerase chain reaction (PCR) confirmed coronavirus 2019 (COVID-19) disease infection at the end of the first month, scores from the psoriasis area severity index (PASI) and dermatological life quality index (DLQI) were regressed significantly within two and a half months. ECP seems to provide an effective and rapid response for psoriasis and should be considered for psoriasis patients who fail to respond or have contraindications to existing treatments.

摘要

银屑病是一种慢性炎症性皮肤病,其特征是边界清楚的红斑上附有银白色鳞屑。虽然许多新出现的治疗药物通常足以控制疾病,但在具有挑战性的病例中,仍需要替代治疗方案。体外光化学疗法(ECP)已应用于许多 T 细胞介导的疾病,以恢复免疫平衡并有效治疗银屑病。在本文中,我们介绍了一位银屑病患者,他对甲氨蝶呤、窄带紫外线 B 或阿维 A 酯治疗无反应。由于诊断为非霍奇金淋巴瘤,该患者对环孢素、富马酸酯和生物制剂有禁忌症,但在两个月半的时间内总共进行了 12 次 ECP 治疗后达到了缓解。尽管在第一个月末聚合酶链反应(PCR)确认 2019 年冠状病毒病(COVID-19)感染后出现了加重,但银屑病面积严重程度指数(PASI)和皮肤病生活质量指数(DLQI)评分在两个月半内显著下降。ECP 似乎为银屑病提供了有效和快速的反应,对于那些对现有治疗无反应或有禁忌症的银屑病患者,应考虑使用 ECP。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5925/8234246/02ae53431fe4/gr1_lrg.jpg

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