Wilkinson S M, Smith A G, Davis M J, Mattey D L, Dawes P T
Dermatology Department, North Staffordshire Hospital Centre, Stoke-on-Trent.
Br J Rheumatol. 1993 Sep;32(9):798-803. doi: 10.1093/rheumatology/32.9.798.
Cutaneous toxicity from drugs used to treat RA is a major perceived problem. Over a 2-yr period we have prospectively reviewed 114 patients with a suspected adverse cutaneous reaction to anti-rheumatic drugs. In 71 (62%), the rash was thought to be unrelated to drug therapy. This group included 10 in whom the rash had resolved before review (usually < 1 week), 38 with a rash related to their rheumatoid disease and 23 with eruptions unrelated to either drugs or arthritis. Forty-three (38%) patients had rashes thought to be related to their drug therapy. Gold therapy (both oral and intramuscular) was implicated most frequently (31 patients). However, the majority of these (23) had a pityriasiform/discoid eczematous eruption that responded to potent topical steroids occasionally with a reduction in gold dosage. In this sample it was possible to continue drug therapy in 82% of patients with what were initially thought to be cutaneous adverse drug reactions. Careful evaluation should allow a majority of patients to continue drug therapy from which they are often gaining benefit.
用于治疗类风湿关节炎（RA）的药物所引起的皮肤毒性是一个被广泛认识到的主要问题。在两年的时间里，我们前瞻性地评估了114例疑似对抗风湿药物有皮肤不良反应的患者。其中71例（62%）的皮疹被认为与药物治疗无关。这一组包括10例在评估前皮疹已消退的患者（通常在1周内）、38例与类风湿疾病相关的皮疹患者以及23例与药物或关节炎均无关的皮疹患者。43例（38%）患者的皮疹被认为与药物治疗有关。金制剂治疗（包括口服和肌肉注射）最常涉及（31例患者）。然而，其中大多数患者（23例）出现了糠疹样/盘状湿疹样皮疹，对强效外用类固醇有反应，偶尔需减少金制剂用量。在这个样本中，82%最初被认为有皮肤药物不良反应的患者能够继续药物治疗。仔细评估应能使大多数患者继续接受药物治疗，而他们通常也能从中获益。
