Scott G A
Department of Dermatology, University of Rochester, NY 14642, USA.
Am J Dermatopathol. 1995 Apr;17(2):107-14. doi: 10.1097/00000372-199504000-00001.
Granulocyte macrophage-colony-stimulating factor (GM-CSF) is a cytokine used to stimulate the growth and maturation of granulocytes and macrophages in a variety of clinical settings. Reported cutaneous side effects of GM-CSF therapy include both local reactions at the site of injection and diffuse eruptions. In this report we describe the clinical and histologic features of three patients who had a widespread macular-papular eruption after GM-CSF therapy to stimulate bone marrow recovery. In all three patients the eruptions occurred within 3 days of starting GM-CSF therapy and resolved after the infusion ended. Histologic features of the eruptions included a mixed infiltrate of lymphocytes, eosinophils, and neutrophils, primarily in the papillary dermis. In all three cases there was an increase in the number of dermal macrophages, and in two cases there was a striking increase in the size of dermal macrophages, many of which contained ingested elastin. We report these cases to alert the reader that alteration in number or size of dermal macrophages is a clue to the diagnosis of GM-CSF-induced dermatoses. A review of the literature of cutaneous side effects of GM-CSF is included.
粒细胞巨噬细胞集落刺激因子（GM-CSF）是一种细胞因子，在多种临床情况下用于刺激粒细胞和巨噬细胞的生长与成熟。GM-CSF治疗报告的皮肤副作用包括注射部位的局部反应和弥漫性皮疹。在本报告中，我们描述了3例接受GM-CSF治疗以促进骨髓恢复后出现广泛斑丘疹的患者的临床和组织学特征。所有3例患者的皮疹均在开始GM-CSF治疗后3天内出现，并在输注结束后消退。皮疹的组织学特征包括淋巴细胞、嗜酸性粒细胞和中性粒细胞的混合浸润，主要位于乳头真皮层。在所有3例病例中，真皮巨噬细胞数量增加，在2例病例中，真皮巨噬细胞大小显著增加，其中许多含有摄入的弹性蛋白。我们报告这些病例以提醒读者，真皮巨噬细胞数量或大小的改变是诊断GM-CSF诱导的皮肤病的线索。本文还包括对GM-CSF皮肤副作用文献的综述。
