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中华结直肠疾病电子杂志 ›› 2016, Vol. 05 ›› Issue (06) : 533 -537. doi: 10.3877/cma.j.issn.2095-3224.2016.06.016

所属专题: 经典病例 经典病例 文献

病例报道

甲磺酸伊马替尼致银屑病一例报道及文献复习
甄亚男1, 肖瑞雪2,(), 石会勇1, 韩钢1, 徐忠法1,()   
  1. 1. 250031 山东省医学科学院附属医院外二科
    2. 250031 山东省医学科学院附属医院病理科
  • 收稿日期:2016-05-09 出版日期:2016-12-25
  • 通信作者: 肖瑞雪, 徐忠法
  • 基金资助:
    山东省医学科学院院级科技计划青年资助项目(No.2014-56); 山东省医学科学院院级科技计划青年资助项目(No.2014-61)

Imatinib-induced psoriasis: a case report and literature review

Yanan Zhen1, Ruixue Xiao2,(), Huiyong Shi1, Gang Han1, Zhongfa Xu1,()   

  1. 1. Department of Gastrointestinal Surgery, Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan 250031, China
    2. Department of Pathology, Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan 250031, China
  • Received:2016-05-09 Published:2016-12-25
  • Corresponding author: Ruixue Xiao, Zhongfa Xu
  • About author:
    Corresponding author: Xu Zhongfa, Email:
    Xiao Ruixue, Email:
引用本文:

甄亚男, 肖瑞雪, 石会勇, 韩钢, 徐忠法. 甲磺酸伊马替尼致银屑病一例报道及文献复习[J]. 中华结直肠疾病电子杂志, 2016, 05(06): 533-537.

Yanan Zhen, Ruixue Xiao, Huiyong Shi, Gang Han, Zhongfa Xu. Imatinib-induced psoriasis: a case report and literature review[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2016, 05(06): 533-537.

目的

对甲磺酸伊马替尼导致的银屑病进行系统探讨,提高临床医生的认识水平。

方法

报道一例应用甲磺酸伊马替尼治疗胃肠道间质瘤诱发银屑病的患者,结合文献对其临床表现、处理原则及其可能的发生机制进行综述。

结果

口服甲磺酸伊马替尼加重或诱发银屑病多发生在服药的3~8周后,临床表现多为躯干、四肢部位的皮疹,或出现银屑病甲。治疗措施多为应用糖皮质激素、紫外线治疗或口服甲氨蝶呤,必要时停药,待皮疹控制后有望继续口服甲磺酸伊马替尼。如皮疹反复发作且较难控制,可考虑更换第二代酪氨酸酶抑制剂。其发病机制可能与抑制T细胞和细胞因子相关。

结论

在应用甲磺酸伊马替尼过程中,应重视银屑病的发生,一旦出现需及时对症处理并严密观察,待症状控制后有继续恢复口服甲磺酸伊马替尼的可能,必要时更换第二代酪氨酸酶抑制剂。

Objective

To analyze imatinib-induced psoriasis systemically in order to make the clinician achieve a better comprehension.

Methods

One GIST patient with imatinib-induced psoriasis was reported. Combined with the literature, the clinical manifestation, treatment principles and its possible mechanism were summarized.

Results

Psoriasis aggravated or induced by imatinib often appeared in 3 to 8 weeks after taking it. Patients always developed rash on his trunk and limbs or psoriasis nail. Treatment measures include using corticosteroid and ultraviolet therapy or taking methotrexate, and drug withdrawal is required when necessary. After the rash controlled expectedly, it was expected to continue to take imatinib. The second-generation TKIs may be considered as an alternative treatment in patients whose rash break out repeatedly and difficult to control. Its pathogenesis may be related to the inhibition of T cells and cytokines.

Conclusions

The psoriasis should be seriously cared during the treatment with imatinib, the treatments for the symptoms and the close observation should be applied in time. It is expected to continue to take imatinib until the symptoms are well controlled. If needed, replace the imatinib with second-generation TKIs.

图1 四肢及躯干皮肤见广泛红色斑丘疹,部分色素沉着,大量皮屑形成,双小腿皮损最严重
图2 患者口服甲磺酸伊马替尼后出现红色斑丘疹,治疗3天后躯干及双下肢皮疹明显减轻
图3 患者停用醋酸泼尼松片,完全停药3天后,躯干及双下肢再次出现皮疹
表1 纳入分析文献的基本情况
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