中华皮肤科杂志 ›› 2014, Vol. 47 ›› Issue (4): 243-246.

• 论著 • 上一篇    下一篇

肿瘤坏死因子拮抗剂治疗重症三氯乙烯药疹样皮炎

丁兰1,路丹丹2,施辛2,孙晓东3,4,闫志华5,6,凌昕7,刘润秋8,季孙平2,黎平9,张静10,陈小建11,陈玲玲12,谢立夏3,13   

  1. 1. 无锡市儿童医院
    2. 苏州大学附属第二医院
    3. 苏州大学附属第二医院皮肤科
    4. 唐山市丰南区妇幼医院
    5. 苏州市第七人民医院
    6.
    7. 吴江市第一人民医院
    8. 盐城市第一人民医院皮肤科
    9. 四川省903医院
    10. 常熟市第一人民医院
    11. 南京医科大学附属苏州医院，苏州市立医院
    12. 南京医科大学附属苏州医院
    13. 成都市第二人民医院
  • 收稿日期:2013-05-13 修回日期:2013-12-04 出版日期:2014-04-15 发布日期:2014-04-01
  • 通讯作者: 施辛 E-mail:shx9@163.com

A tumor necrosis factor antagonist in the treatment of severe medicamentosa-like dermatitis induced by trichloroethylene: a clinical observation

1, Xiao-Dong SUN1,3,zhihua 1,1,leon liu runqiu4, 1,Ping Li1,Jing Zhang1,xiao-jian CHEN5,lingling CHENLi-Xia XIE1,1   

  • Received:2013-05-13 Revised:2013-12-04 Online:2014-04-15 Published:2014-04-01

PDF

9

赞

摘要： 【摘要】 目的 观察肿瘤坏死因子拮抗剂在重症三氯乙烯药疹样皮炎治疗中的作用。 方法 5例以皮疹、发热、浅表淋巴结肿大和肝、肾损害为主要表现的重症三氯乙烯药疹样皮炎患者，在判断无肿瘤、结核及重症感染后，3例采用肿瘤坏死因子拮抗剂25 mg皮下注射，每周2次，联合糖皮质激素治疗；2例单独使用肿瘤坏死因子拮抗剂治疗。 结果 肿瘤坏死因子拮抗剂联合糖皮质激素治疗的3例患者体温在1周内降至正常，住院期间未发生感染、急性肝功能衰竭等，出院时皮疹消退，口腔、外阴等黏膜恢复正常，肝肾功能正常，平均住院时间36 d。单独使用肿瘤坏死因子拮抗剂的2例患者均治愈，临床疗效与联合糖皮质激素治疗的患者无明显差别，治疗后28周测得血清肿瘤坏死因子α水平降至正常。 结论 在重症三氯乙烯药疹样皮炎的治疗过程中尽早、足量使用肿瘤坏死因子拮抗剂有益于快速控制病情。

关键词: 三氯乙烯, 药疹, 肿瘤坏死因子拮抗剂, 药物疗法

Abstract: Ding Lan, Lu Dandan, Shi Xin, Sun Xiaodong, Yan Zhihua, Ling Xin, Liu Runqiu, Ji Sunping, Li Ping, Zhang Jing, Chen Xiaojian, Chen Lingling, Xie Lixia. Department of Dermatology, Second Affiliated Hospital of Soochow University, Suzhou 215004, China Corresponding author: Shi Xin, Email: shx9@163.com 【Abstract】 Objective To estimate the effect of a tumor necrosis factor antagonist in the treatment of medicamentosa-like dermatitis induced by trichloroethylene. Methods Five patients, who presented with skin eruptions, fever, superficial lymphadenectasis, hepatic and renal damage, were diagnosed with severe medicamentosa-like dermatitis induced by trichloroethylene. Of them, three patients, who had been confirmed not to have tumor, tuberculosis or severe infection, were treated with a recombinant human tumor necrosis factor antagonist （25 mg, subcutaneous injection, twice per week） combined with glucocorticoid, and the other two patients were treated with the tumor necrosis factor antagonist alone. Results In the three patients treated with the tumor necrosis factor antagonist combined with glucocorticoid, body temperature dropped into the normal range within a week. No infection or acute hepatic failure was observed during their hospitalizations. When they were discharged from hospital, the skin rashes subsided, oral and vulval mucosae were recovered, and hepatic and renal function was restored, with the median hospital stay being 36 days. The other two patients treated with the tumor necrosis factor antagonist alone were also cured, and the serum level of tumor necrosis factor-α returned to normal on week 28 after initiation of treatment. There was no significant difference in clinical efficacy between the combination therapy and monotherapy. Conclusion To use a tumor necrosis factor antagonist at an adequate dose as early as possible is beneficial to the treatment of severe medicamentosa-like dermatitis induced by trichloroethylene.

Key words: Trichloroethylene, Drug eruptions, Tumor necrosis factor antagonist, Drug therapy