Denis P, Nordmann J P, Saiag P, Liotet S, Laroche L, Saraux H
Service d'Ophtalmologie, Hôpital Saint-Antoine, Paris.
J Fr Ophtalmol. 1993;16(3):191-4.
We report external ocular side effects after treatment with acitretin, a new synthetic vitamin A analogue and the main metabolite of etretinate. A patient treated with 20-25 mg/day of acitretin for psoriasis suffered from chronic blepharoconjunctivitis. Schirmer tests, tear lysozyme were normal while rose bengal and fluorescein staining disclosed epithelial punctate defects and tear break-up time was shortened. Meibomian glands of the lower lid were photographed with transillumination and appeared atrophic. Conjunctival cytology and biopsy showed snake-like chromatine appearance, keratinized epithelial cells and some lymphocytes infiltrates. Accessory salivary gland histological aspects were nonspecific. There was a clear relationship between restarting the acitretin therapy and recurrence of ocular symptoms. Acitretin, like other retinoids, may induce or exacerbate blepharoconjunctivitis in patients with psoriasis.
我们报告了使用阿维A（一种新的合成维生素A类似物及依曲替酯的主要代谢产物）治疗后的眼外副作用。一名每天服用20 - 25毫克阿维A治疗银屑病的患者患上了慢性睑结膜炎。泪液分泌试验、泪液溶菌酶正常，而孟加拉玫瑰红和荧光素染色显示上皮点状缺损，泪膜破裂时间缩短。通过透照法拍摄下睑睑板腺，显示其萎缩。结膜细胞学检查和活检显示出蛇样染色质外观、角化上皮细胞以及一些淋巴细胞浸润。副涎腺组织学表现无特异性。重新开始阿维A治疗与眼部症状复发之间存在明显关联。阿维A与其他维甲酸类药物一样，可能会诱发或加重银屑病患者的睑结膜炎。
