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慢性舌溃疡作为组织胞浆菌病的一种表现，出现在银屑病患者接受抗肿瘤坏死因子-α（TNF-α）抑制剂治疗期间。

Chronic Ulcer on the Tongue as a Manifestation of Histoplasmosis During Anti-tumor Necrosis Factor-Alpha (TNF-⍺) Inhibitor Therapy for Psoriasis.

作者信息

Harrison Iris, Forouzandeh Mahtab, Motaparthi Kiran

机构信息

Department of Dermatology, University of Florida College of Medicine, Gainesville, USA.

出版信息

Cureus. 2023 Sep 14;15(9):e45217. doi: 10.7759/cureus.45217. eCollection 2023 Sep.

DOI:10.7759/cureus.45217
PMID:37720115
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10500618/
Abstract

Anti-tumor necrosis factor-alpha (TNF-⍺) inhibitors are commonly used in the treatment of inflammatory conditions such as psoriasis. However, these agents lead to increased susceptibility to infections. We report a patient with reactivation of latent histoplasmosis six months after starting an anti-TNF-⍺ inhibitor for the treatment of psoriasis. Dermatologists should be aware of the risks associated with initiating therapy and maintain a low threshold of suspicion for this infection in patients on anti-TNF-⍺ inhibitors presenting with oral ulcers.

摘要

抗肿瘤坏死因子-α（TNF-α）抑制剂常用于治疗银屑病等炎症性疾病。然而，这些药物会导致感染易感性增加。我们报告了一名患者，在开始使用抗TNF-α抑制剂治疗银屑病六个月后，潜伏性组织胞浆菌病复发。皮肤科医生应意识到开始治疗相关的风险，并对出现口腔溃疡的抗TNF-α抑制剂治疗患者保持对这种感染的低怀疑阈值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc91/10500618/61088275ed19/cureus-0015-00000045217-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc91/10500618/e0d316f291e0/cureus-0015-00000045217-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc91/10500618/d0f26e58e17e/cureus-0015-00000045217-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc91/10500618/61088275ed19/cureus-0015-00000045217-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc91/10500618/e0d316f291e0/cureus-0015-00000045217-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc91/10500618/d0f26e58e17e/cureus-0015-00000045217-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc91/10500618/61088275ed19/cureus-0015-00000045217-i04.jpg

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本文引用的文献

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Prevalence of Oral Lesions and Correlation with Intestinal Symptoms of Inflammatory Bowel Disease: A Systematic Review.炎症性肠病口腔病变的患病率及其与肠道症状的相关性：一项系统评价
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口腔坏疽性脓皮病：诊断、治疗及挑战：一项系统综述
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Worldwide Phylogenetic Distributions and Population Dynamics of the Genus Histoplasma.组织胞浆菌属的全球系统发育分布及种群动态
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Cutaneous histoplasmosis as a complication after anti-TNF use--Case report.抗 TNF 治疗后并发皮肤组织胞浆菌病——病例报告
An Bras Dermatol. 2015 May-Jun;90(3 Suppl 1):104-7. doi: 10.1590/abd1806-4841.20153545.
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Histoplasmosis complicating tumor necrosis factor-α blocker therapy: a retrospective analysis of 98 cases.组织胞浆菌病并发肿瘤坏死因子-α阻滞剂治疗：98例回顾性分析
Clin Infect Dis. 2015 Aug 1;61(3):409-17. doi: 10.1093/cid/civ299. Epub 2015 Apr 13.
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