培塞利珠单抗诱发强直性脊柱炎患者银屑病样皮疹一例-现代医学

培塞利珠单抗诱发强直性脊柱炎患者银屑病样皮疹一例

单位：哈尔滨医科大学附属第一医院风湿免疫科, 黑龙江哈尔滨 150001

分类号：R593-23

出版年·卷·期（页码）：2022·50·第八期（1069-1071）

摘要：

聚乙二醇化和缺少Fc片段的培塞利珠单抗是独一无二的肿瘤坏死因子拮抗剂，目前国内外报道了两例其治疗强直性脊柱炎诱发银屑病的案例。治疗强直性脊柱炎出现银屑病时，由于强直性脊柱炎和中轴型银屑病关节炎鉴别有一定困难，易误诊、漏诊，且目前尚无公认的治疗方案。本院一患者因强直性脊柱炎注射培塞利珠单抗后出现银屑病样皮疹，腰椎X线片显示强直性脊柱炎不典型骨赘，诊断为强直性脊柱炎、银屑病样皮疹，停药4个月后皮疹基本消失，腰背痛加重，改用司库奇尤单抗后疗效可。

Certolizumab with polyethylene glycol and lacking Fc fragment is a unique tumor necrosis factor antagonist,with which two cases of psoriasis induced by ankylosing spondylitis (AS) have been reportedly treated at home and abroad.When psoriasis occurs in the treatment of AS,it is difficult to distinguish AS from axial psoriatic arthritis (AxPsA),which is easy to be misdiagnosed and missed,and there is no recognized treatment plan at present.A patient with AS developed psoriatic rash after injection of certolizumab,and the lumbar vertebrae showed atypical osteophytes in AS.The diagnosis was AS and psoriatic dermatitis.After 4 months of withdrawal,the rash basically disappeared and low back pain worsened.After switching to the use of Secukinumab the curative effect can be achieved.

参考文献：

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