司库奇尤单抗治疗甲银屑病致局部湿疹样皮炎1例

Local Eczema-Like Dermatitis Caused by Secukinumab in the Treatment of Nail Psoriasis:A Case Report

患者女,18岁,手足部分指甲甲剥离伴疼痛5年余。皮肤科情况:患者双足踇趾趾甲、左手3枚指甲和右手2枚指甲可见甲凹点、甲剥离及甲下角化过度,甲周皮肤可见鳞屑。甲纵行活检:近端甲皱襞、甲母质、甲床及甲下皮可见角化过度,角化不全,表皮银屑病样增生。诊断:甲银屑病。予司库奇尤单抗皮下注射治疗半年后甲恢复正常,但左足背部出现红斑、渗出、结痂,约3 cm×4 cm大小,伴明显瘙痒,考虑为司库奇尤单抗引起的湿疹样改变。患者外用糠酸莫米松乳膏治疗1周后皮疹好转。随访8个月后,患者病情持续好转。

An 18-year-old female patient had partial onycholysis with pain for more than 5 years.Physical examination showed nail pits,onycholysis,subungual hyperkeratosis and scales in the periungual skin,on her both toe nails,3 nails in the left hand and 2 nails in the right hand.Nail longitudinal biopsy showed proximal nail fold,nail matrix,nail bed and nail skin hyperkeratosis,parakeratosis,epidermal psoriasis-like hyperplasia.Diagnosis:nail psoriasis.After half a year of subcutaneous injection of secukinumab,the nails were basically cured.However,erythema,exudation,and scabbing appeared on the dorsum of the left foot,measuring about 3 cm×4 cm,with obvious pruritus.It was considered as eczematous changes caused by secukinumab.The patient used topical application of mometasone furoate cream for one week and the rash improved.After 8 months of follow-up,the patient improved.