肿瘤坏死因子α抑制剂治疗化脓性汗腺炎四例

Tumor necrosis factor-αinhibitors for the treatment of four cases of hidradenitis suppurativa

报道2017年8月至2019年12月第四军医大学西京皮肤医院收治的4例化脓性汗腺炎,年龄20-45岁,均为男性,皮损表现为腋窝、臀部、腹股沟的窦道、脓肿、瘢痕,Hurley分期Ⅱ~Ⅲ期。既往使用抗生素、糖皮质激素、维A酸类药物、中药等多种治疗方案,改善均不明显。予静脉滴注英夫利西单抗5 mg/kg,第0、2、6周各1次,后每间隔8周1次;或皮下注射阿达木单抗,第0、2周各80 mg/次,后每间隔2周40 mg/次。2例静脉滴注英夫利西单抗后出现输液反应,改用阿达木单抗。3例达到化脓性汗腺炎临床反应(HiSCR),1例无效。

Four male cases of hidradenitis suppurativa(Hurley stageⅡ/Ⅲ)aged 20-45 years were collected from Department of Dermatology,Xijing Hospital,the Fourth Military Medical University from August 2017 to December 2019.All the patients presented with sinuses,abscesses and scars on the buttocks,axillary and inguinal regions,and showed a poor response to previous treatment with antibiotics,glucocorticoids,retinoids,traditional Chinese medicine,etc.The patients were treated with intravenous drips of infliximab at a dose of 5 mg/kg at weeks 0,2 and 6,followed by an every-9-week treatment regimen,or with subcutaneous injection of adalimumab at a dose of 80 mg at weeks 0 and 2,followed by an every-3-week regimen at a dose of 40 mg.Two patients experienced infusion reactions after intravenous drips of infliximab,and then were switched to adalimumab.Three of these patients achieved hidradenitis suppurativa clinical response,whereas 1 showed no response.