阿达木单抗诱发银屑病样皮炎1例

A Case of Adalimumab-Induced Psoriasiform Dermatitis

患者男,25岁,双足红斑、丘疹伴瘙痒4+个月,累及双手1个月。发疹前1 d患者因“强直性脊柱炎”予阿达木单抗第4次注射。皮损组织病理示:表皮明显角化过度,棘层增生,真皮浅层小血管周围稀疏淋巴细胞浸润。诊断:①银屑病样皮炎;②强直性脊柱炎。停用生物制剂,处理予外擦药后皮疹逐渐消退,非甾体类抗炎药和甲泼尼龙控制强直性脊柱炎。

A 25-year-old male presented erythema and papules on feet and itching for four months,with hands involved for a month.One day before skin rashes,he received Adalimumab for the treatment of ankylosing spondylitis for the fourth time.Histopathological examination showed hyperkeratosis of epidermis and hyperplasia of spinous layer,with infiltration of few lymphocytes around small vessels located in the superficial dermis.Diagnoses of psoriasiform dermatitis and ankylosing spondylitis were made.The biological agent was stopped and skin lesions disappeared gradually after topical treatments.Non-steroid anti-inflammatory drugs and Methylprednisolone were given in order to control ankylosing spondylitis.