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在患有无氧性皮肤炎的患者中与杜皮卢马布相关的淋巴状反应
Celeste M Boesjes1, Lian F van der Gang1, Daphne S Bakker1
1Department of Dermatology and Allergology, National Expertise Center for Atopic Dermatitis, University Medical Center Utrecht, Utrecht, the Netherlands.
JAMA dermatology
|October 18, 2023
概括
对阿托皮性皮炎的杜皮卢马布治疗可能会引起一种良性淋巴状反应,模仿皮肤T细胞淋巴瘤. 这种可逆性状况具有明显的组织病理特征,并在停止治疗后消失.
科学领域:
- 皮肤病学 皮肤病学
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 杜皮卢马布越来越多地用于亚托皮性皮肤炎 (AD).
- 报告表明dupilumab与皮肤T细胞淋巴瘤 (CTCL) 或淋巴细胞透物之间存在联系.
- 这些病例的临床和组织病理特征需要澄清.
研究的目的:
- 为了调查在杜皮卢马布治疗中患有AD的患者,他们发展了可疑的CTCL.
- 描述这些病例的临床和组织病理特征.
- 要区分CTCL和其他淋巴细胞反应.
主要方法:
- 成年阿尔茨海默病患者接受杜皮卢马布治疗的回顾性观察病例系列 (2017年10月-2022年7月).
- 评估患者,疾病和治疗特征.
- 重新评估在治疗前,治疗期间和治疗后进行的皮肤活检.
主要成果:
- 包括14名怀疑在杜皮卢马布治疗期间患有CTCL的患者.
- 三名患者有先前存在的真菌菌菌病 (MF);11人有淋巴细胞反应 (LR).
- LR病例表现出类似于MF的症状,但具有不同的组织病理 (例如,特定的淋巴细胞分布,CD4:CD8比率,CD30过度表达) 并在治疗后清除.
结论:
- 杜皮卢马布可以诱导一种可逆的良性淋巴状反应,模仿AD患者的CTCL.
- 这种淋巴细胞反应表现出明显的组织病理特征,使其与真正的CTCL有所区别.
- 了解这些特征对于准确的诊断和管理至关重要.
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