麦考酚酯联合阿维A治疗难治性脓疱型银屑病5例临床观察

Combination of Mycophenolate Mofetil and Acitretin Therapy for Refractory Pustular Psoriasis

目的观察小剂量麦考酚酯联合阿维A治疗难治性泛发性脓疱型银屑病的疗效及安全性。方法对本科住院治疗的5例既往予阿维A单独或联合其他药物治疗无效的泛发性脓疱型银屑病患者,分析在予麦考酚酯0.5g(2次/d)联合阿维A 30mg(1次/d)治疗后的疗效及安全性。结果该5例患者联合治疗平均显效时间为2.8天,3例8天内好转出院,1例8天时痊愈出院,治疗及随访中均未发现麦考酚酯或阿维A相关的不良反应,1例复发。结论小剂量麦考酚酯联合阿维A治疗难治性泛发性脓疱型银屑病起效快,可供单独使用阿维A或联合其他药物治疗抵抗的患者选择,无明显不良反应。

Objective To investigate the efficacy and safety of low-dose mycophenolate mofetil （MMF） combined with acitretin in treating refractory generalized pustular psoriasis. Methods The combinational therapy with MMF（0. 5 twice a day） and acitretin（30mg once a day） were administered orally in five hospitalized patients with generalized pustular psoriasis who failed on treatment with acitretin alone or in combination with other medications, and its efficacy and safety were evaluated. Results The mean time to get improvement after combinational therapy is 2. 8 days. Three patients were discharged with good response within 8 days, and 1 patient had a well-healed response at 8 days. No adverse effects related to MMF or acitretin were observed either during hospitalization or in follow-up period. There was only one patient experiencing relapse. Conclusion Our study indicates the rapid improvement in the treatment for refractory generalized pustular psoriasis with low-dose MMF and acitretin combined. It would be an alternative regimen for the patients who were refractory to treatment of acitretin alone or in combination with other medication, with no significant adverse effects.