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免疫疗法诱导的纯粹皮肤样反应
Anika Mazumder1, Sino Mehrmal2, Sofia Chaudhry3
1Saint Louis University School of Medicine, Saint Louis, Missouri, USA.
BMJ case reports
|July 18, 2023
概括
类反应 (SLR) 是对免疫检查点抑制剂 (ICI) 的罕见炎症反应. 这一案例突出显示了一种完全基于皮肤的SLR模仿皮肤肌炎,强调了在诊断新爆发时需要进行皮肤活检的必要性.
科学领域:
- 免疫学 免疫学 免疫学
- 皮肤病学 皮肤病学
- 在瘤学瘤学.
背景情况:
- 类反应 (SLRs) 是不常见的粒状炎症性炎症反应.
- 免疫检查点抑制剂 (ICI) 可以触发影响各种器官的SLR,特别是肺,淋巴结和皮肤.
- 皮肤SLR很罕见,特别是在没有系统性参与的情况下出现时.
研究的目的:
- 报告一种罕见的皮肤上样反应 (SLR) 病例,该病例是由pembrolizumab引起的.
- 为了突出这一SLR的临床表现,它模仿了皮肤肌炎.
- 审查有关免疫检查点抑制剂诱导的皮肤SLR的文献.
主要方法:
- 病例介绍:一个患者对 pembrolizumab 产生了不良反应.
- 临床评估和诊断工作,包括皮肤活检的组织学评估.
- 对以前报告的ICI诱导皮肤SLR病例进行了全面的文献综述.
主要成果:
- 由于 pembrolizumab,该患者开发了一个完全皮肤SLR,呈现模仿皮肤肌炎的症状.
- 在文献审查中,只发现了12例ICI诱导的皮肤SLR病例,没有系统性表现.
- 组织学检查对于诊断皮肤SLR至关重要.
结论:
- 针对免疫检查点抑制剂的纯皮肤类反应可能呈现出各种临床特征,包括模仿皮肤肌炎.
- 新皮疹的组织学评估对于准确诊断和ICI诱导的SLRs的管理至关重要.
- 这一案例强调了免疫检查点抑制剂毒性的各种表现,以及在接受这些治疗的患者中考虑SLR的重要性.
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