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