Hsieh Chang-Yu, Yu Shan-Chi, Lee Jia-Arng, Tsai Tsen-Fang
From the Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan.
Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan.
Indian J Dermatol. 2024 May-Jun;69(3):264-267. doi: 10.4103/ijd.ijd_93_23. Epub 2024 Jun 26.
Biologics have expanded the armamentarium for psoriasis, but there has been a growing concern about the risk of lymphoma in patients under tumour necrosis factor (TNF)-α inhibitor and methotrexate. Besides, the mRNA-based coronavirus disease 2019 (COVID-19) vaccination was known to stimulate the proliferation of T-follicular helper cells. We report a case of a patient with psoriasis under adalimumab developing nodal T-follicular helper cell lymphoma, angioimmunoblastic-type following the mRNA-1273 COVID-19 vaccine. We suspect that adalimumab, methotrexate, Epstein-Barr virus (EBV) reactivation, previous reactive lymphoid hyperplasia and psoriasis per se predispose our patient to a lymphoma-prone condition, and the two doses of the mRNA vaccine act as the last straw.
生物制剂扩大了银屑病的治疗手段，但人们越来越担心肿瘤坏死因子（TNF）-α抑制剂和甲氨蝶呤治疗的患者发生淋巴瘤的风险。此外，已知基于信使核糖核酸（mRNA）的2019冠状病毒病（COVID-19）疫苗会刺激T滤泡辅助细胞增殖。我们报告了1例接受阿达木单抗治疗的银屑病患者，在接种mRNA-1273 COVID-19疫苗后发生了结节性T滤泡辅助细胞淋巴瘤，血管免疫母细胞型。我们怀疑阿达木单抗、甲氨蝶呤、爱泼斯坦-巴尔病毒（EBV）再激活、既往反应性淋巴样增生以及银屑病本身使我们的患者易患淋巴瘤倾向状态，而两剂mRNA疫苗则成为导火索。
