在单一中心通过回顾性图表审查对TNF-α抑制剂诱导的悖论性牛皮形皮肤炎的表征
Muayad M Shahin1, Emily S Gorell2, Mariam Iqneibi3
1University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Pediatric dermatology
|January 29, 2026
概括
瘤坏死因子-α抑制剂 (TNFi) 可以导致牛皮形皮炎 (PD). 女性性别与PD严重程度相关,而青少年异形性关节炎,老年和免疫调节剂与儿科患者的PD发病延迟有关.
科学领域:
- 皮肤病学 皮肤病学
- 免疫学 免疫学 免疫学
- 儿科 儿科 儿科
背景情况:
- 瘤亡因子α抑制剂 (TNFi) 对于治疗自身免疫性疾病至关重要.
- 一部分接受TNFi治疗的患者患有悖论性牛皮形皮肤炎 (PD).
- 了解PD严重程度和潜伏期的风险因素对于患者管理至关重要.
研究的目的:
- 确定与TNFi诱导的牛皮形皮肤炎 (PD) 在儿科患者的严重程度相关的风险因素.
- 分析影响PD发展前潜伏期的因素.
- 为了评估TNFi停药后的治疗结果.
主要方法:
- 70名被诊断患有TNFi诱导的PD的儿科患者的回顾性图表审查.
- 对人口统计,临床和治疗数据的分析.
- 统计分析以确定PD严重程度和潜伏期的风险因素.
主要成果:
- 女性性别与使用高强度局部类固醇的增加有关,这表明PD严重程度更大 (p=0.01).
- 青春期异常性关节炎 (p=0.02),年龄较大 (p<0.01) 和同时使用免疫调节剂 (p=0.04) 与PD的延长潜伏期有关.
- 57.1%的患者停止了最初的TNFi,30.0%的患者转换为另一种TNFi,33.3%的患者患有PD复发.
结论:
- 女性性别可能表明在儿童中更严重的TNFi诱导的PD.
- 特定的患者特征,如青少年异常性关节炎,年龄较大和免疫调节剂使用,都会影响PD发病的时间.
- 对TNFi诱导的PD的治疗策略需要仔细考虑患者特异性因素和复发潜力.
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