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甲状腺癌放射性碘治疗后碘疹:2例病例分析

Iododerma Following Radioactive Iodine Therapy in Thyroid Cancer: Insights From 2 Cases.

作者信息

Kamal Hawra, Samantray Julie

机构信息

Division of Endocrinology, Wayne State University/Detroit Medical Center, Detroit, MI 48201, USA.

出版信息

JCEM Case Rep. 2025 Apr 10;3(5):luaf056. doi: 10.1210/jcemcr/luaf056. eCollection 2025 May.

Abstract

Radioactive iodine ablation is commonly used to treat thyroid diseases. However, despite its efficacy, it has inherent risks and complications. One such complication is iododerma. This rare dermatological condition triggered by iodine exposure has been infrequently documented in association with radioactive iodine therapy for thyroid diseases. Here, we present 2 cases of iododerma following radioactive iodine ablation for thyroid cancer. In the first case, a 38-year-old female developed facial swelling and red blotchy rashes accompanied by papules on the left upper eyelid. Despite initial worsening of symptoms, the patient improved after prednisone treatment. In the second case, a 71-year-old male with metastatic follicular thyroid cancer received iodine-131 therapy after levothyroxine withdrawal for pulmonary metastasis. Approximately 1 week posttherapy, he developed a nontender, nonpruritic rash on the extremities and anterior abdomen, which spontaneously resolved without intervention. Iododerma presents diagnostic challenges because of its rarity and diverse cutaneous manifestations. Although its exact pathophysiology remains unclear, it has been hypothesized to be induced by hypersensitivity reactions to and delayed clearance of iodine from the body. Physicians should be aware of this rare complication of radioactive iodine in patients with thyroid disease.

摘要

放射性碘消融常用于治疗甲状腺疾病。然而,尽管其疗效显著,但仍存在固有的风险和并发症。其中一种并发症是碘疹。这种由碘暴露引发的罕见皮肤病与甲状腺疾病放射性碘治疗相关的记录很少。在此,我们报告2例甲状腺癌放射性碘消融术后发生碘疹的病例。第一例,一名38岁女性出现面部肿胀和红色斑疹,左上眼睑伴有丘疹。尽管症状最初有所加重,但患者在接受泼尼松治疗后病情好转。第二例,一名71岁患有转移性滤泡性甲状腺癌的男性在停用左甲状腺素以治疗肺转移后接受了碘 - 131治疗。治疗后约1周,他在四肢和前腹部出现了无压痛、无瘙痒的皮疹,未经干预自行消退。碘疹因其罕见性和多样的皮肤表现而带来诊断挑战。尽管其确切的病理生理机制仍不清楚,但据推测是由对碘的超敏反应和碘在体内清除延迟所致。医生应了解甲状腺疾病患者中这种放射性碘的罕见并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d42a/11982607/6e5ef487dc56/luaf056f1.jpg

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