Zahn Carole Anouk, Feldmeyer Laurence, Blum Roland, Mainetti Carlo
Department of Dermatology, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
Department of Dermatology, Inselspital, University Hospital, Bern, Switzerland.
Case Rep Dermatol. 2022 May 30;14(2):144-150. doi: 10.1159/000524514. eCollection 2022 May-Aug.
The appearance of morphea after radiotherapy, especially in the context of breast cancer, is a rare but known phenomenon. The incidence of post-irradiation morphea (PIM) of the breast is approximately one in every 500 patients, a higher rate than morphea of any other etiology, which is three per 100000 per year. PIM usually appears less than 1 year after irradiation (range 1 month to 32 years). The histological pattern of PIM is different from the one in post-irradiation fibrosis, which is a common side effect of radiotherapy and usually appears during the first 3 months after irradiation. Several theories have been proposed to explain the pathogenesis of PIM, probably caused by a disturbance of the cytokine pattern. The development of PIM in patients with autoimmune diseases has been described in the literature. To our knowledge, we report the first case of PIM in a patient with subacute cutaneous lupus erythematosus. We should therefore pay attention when looking at patients with PIM to search for an underlying autoimmune disease.
放疗后硬斑病的出现,尤其是在乳腺癌的背景下,是一种罕见但已知的现象。乳腺放疗后硬斑病(PIM)的发病率约为每500例患者中有1例,高于任何其他病因导致的硬斑病,后者每年每10万人中有3例。PIM通常在放疗后不到1年出现(范围为1个月至32年)。PIM的组织学模式与放疗后纤维化不同,放疗后纤维化是放疗的常见副作用,通常在放疗后的前3个月出现。已经提出了几种理论来解释PIM的发病机制,可能是由细胞因子模式紊乱引起的。文献中描述了自身免疫性疾病患者中PIM的发生情况。据我们所知,我们报告了第一例亚急性皮肤型红斑狼疮患者发生PIM的病例。因此,在观察PIM患者时,我们应该注意寻找潜在的自身免疫性疾病。