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使用司库奇尤单抗成功治疗合并慢性乙型肝炎的泛发性脓疱型银屑病:一例报告

Successful treatment of generalized pustular psoriasis with chronic hepatitis B using spesolimab: A case report.

作者信息

Ming Ruiyuan, Zhang Lei, Xiong Xincai

机构信息

Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.

出版信息

Medicine (Baltimore). 2025 Apr 25;104(17):e41979. doi: 10.1097/MD.0000000000041979.

DOI:10.1097/MD.0000000000041979
PMID:40295264
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12040035/
Abstract

RATIONALE

Generalized pustular psoriasis (GPP) is a severe form of pustular psoriasis, which can endanger the patient life. However, the conventional treatment for GPP presents several limitations.

PATIENT CONCERNS

In this report, we present a 54-year-old male patient with GPP and chronic hepatitis B. The use of glucocorticoids and acitretin for GPP caused liver injury in our case.

DIAGNOSES

The patient was diagnosed with GPP with chronic hepatitis B.

INTERVENTIONS

The patient accepted traditional therapy, including glucocorticoids and acitretin. The use of glucocorticoids and acitretin for GPP caused liver injury in our case. Therefore, acitretin was discontinued (but not the glucocorticoid). After excluding contraindications, the patient was administered a single dose of spesolimab (900 mg).

OUTCOMES

The rash resolved within 48 hours after the patient was administered a single dose of spesolimab (900 mg).

LESSONS

Our study shows that spesolimab could be employed as a safe and effective therapeutic option for patients with GPP and other underlying conditions.

摘要

原理

泛发性脓疱型银屑病(GPP)是脓疱型银屑病的一种严重形式,可危及患者生命。然而,GPP的传统治疗存在一些局限性。

患者关注

在本报告中,我们介绍了一名54岁的男性GPP患者,同时患有慢性乙型肝炎。在我们的病例中,使用糖皮质激素和阿维A治疗GPP导致了肝损伤。

诊断

该患者被诊断为患有慢性乙型肝炎的GPP。

干预措施

患者接受了包括糖皮质激素和阿维A在内的传统治疗。在我们的病例中,使用糖皮质激素和阿维A治疗GPP导致了肝损伤。因此,停用了阿维A(但未停用糖皮质激素)。在排除禁忌症后,给患者单次注射司库奇尤单抗(900mg)。

结果

患者单次注射司库奇尤单抗(900mg)后48小时内皮疹消退。

经验教训

我们的研究表明,司库奇尤单抗可作为GPP及其他基础疾病患者的一种安全有效的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e4d/12040035/adf6414366d0/medi-104-e41979-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e4d/12040035/f916a9a58c62/medi-104-e41979-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e4d/12040035/adf6414366d0/medi-104-e41979-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e4d/12040035/f916a9a58c62/medi-104-e41979-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e4d/12040035/adf6414366d0/medi-104-e41979-g002.jpg

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本文引用的文献

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Biologics for generalized pustular psoriasis: a systematic review and single-arm meta-analysis.生物制剂治疗泛发性脓疱型银屑病:系统评价和单臂荟萃分析。
Front Immunol. 2024 Oct 14;15:1462158. doi: 10.3389/fimmu.2024.1462158. eCollection 2024.
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A case of generalized pustular psoriasis complicated with SLE successfully treated with spesolimab.司库奇尤单抗成功治疗1例泛发性脓疱型银屑病合并系统性红斑狼疮的病例。
J Dermatol. 2024 Oct;51(10):e335-e336. doi: 10.1111/1346-8138.17243. Epub 2024 Apr 28.
3
Successful treatment of recalcitrant generalized pustular psoriasis of pregnancy with spesolimab.
成功应用 spesolimab 治疗难治性妊娠泛发性脓疱型银屑病。
J Dermatolog Treat. 2024 Dec;35(1):2334791. doi: 10.1080/09546634.2024.2334791. Epub 2024 Apr 2.
4
Successful treatment of acrodermatitis continua of Hallopeau coexisting with generalized pustular psoriasis with spesolimab: a case report.司库奇尤单抗成功治疗合并泛发性脓疱型银屑病的Hallopeau连续性肢端皮炎:一例报告
Front Immunol. 2024 Feb 23;15:1338285. doi: 10.3389/fimmu.2024.1338285. eCollection 2024.
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A case of generalized pustular psoriasis with discrepant resolution time between pustules and erythema after treatment with spesolimab.一例使用司库奇尤单抗治疗后脓疱与红斑消退时间不一致的泛发性脓疱型银屑病病例。
J Dermatol. 2024 Apr;51(4):e127-e128. doi: 10.1111/1346-8138.17032. Epub 2023 Nov 13.
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[Remission of recalcitrant generalized pustular psoriasis under interleukin-36 receptor inhibitor spesolimab].[白细胞介素-36受体抑制剂司帕索利单抗治疗下顽固性泛发性脓疱型银屑病的缓解]
Dermatologie (Heidelb). 2023 May;74(5):356-359. doi: 10.1007/s00105-023-05140-7. Epub 2023 Mar 21.
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Current management of generalized pustular psoriasis.泛发性脓疱型银屑病的治疗现状。
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Trial of Spesolimab for Generalized Pustular Psoriasis.特索利单抗治疗泛发性脓疱型银屑病的试验。
N Engl J Med. 2021 Dec 23;385(26):2431-2440. doi: 10.1056/NEJMoa2111563.
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Int J Mol Sci. 2021 Apr 21;22(9):4344. doi: 10.3390/ijms22094344.
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