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一名患有坏疽性脓皮病的患者感染新冠病毒后接受皮质类固醇和大剂量环孢素治疗的应对措施

Dealing with Corticosteroid and High-Dose Cyclosporine Therapy in a Pyoderma Gangrenosum Patient Contracting a COVID-19 Infection.

作者信息

May Marcella Ricardis, Rübben Albert, Lennertz Andrea, Vanstreels Luk, Leijs Marike

机构信息

Department of Dermatology and Allergology, University Hospital of the RWTH Aachen University, 52074 Aachen, Germany.

Department of Dermatology, St. Nikolaus Hospital, 4700 Eupen, Belgium.

出版信息

J Pers Med. 2022 Jan 27;12(2):173. doi: 10.3390/jpm12020173.

Abstract

Pyoderma gangrenosum (PG) is a rare and chronic neutrophil inflammation belonging to the spectrum of autoinflammatory disorders. Immunosuppressive therapy is the cornerstone of successful treatment. However, due to the global COVID-19 pandemic, physicians struggle with therapeutic strategies during infection. This paper describes the case of a 58-year-old patient with a very painful, rapidly increasing wound on his right foot, which was diagnosed as pyoderma gangrenosum. Five weeks after the initial treatment with high-dose immunosuppressives (combination therapy with cyclosporine A and systemic methylprednisolone), he became infected with COVID-19. Reduction in the immunosuppressive dosage proved effective, as the patient recovered from COVID-19 without any complication and showed rapid wound healing.

摘要

坏疽性脓皮病(PG)是一种罕见的慢性中性粒细胞炎症,属于自身炎症性疾病范畴。免疫抑制治疗是成功治疗的基石。然而,由于全球新冠疫情,医生在感染期间难以抉择治疗策略。本文描述了一名58岁患者的病例,其右脚有一处疼痛剧烈、迅速增大的伤口,被诊断为坏疽性脓皮病。在初始使用高剂量免疫抑制剂(环孢素A和全身性甲泼尼龙联合治疗)治疗五周后,他感染了新冠病毒。事实证明,减少免疫抑制剂量是有效的,因为患者从新冠病毒感染中康复,未出现任何并发症,且伤口愈合迅速。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68b5/8875703/9a25895f0d8d/jpm-12-00173-g001.jpg

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