文献简介

出版社:American Journal of Clinical Dermatology

作  者:Christina Dai · Shawn Shih · Ahmed Ansari · Young Kwak · Naveed Sami

编  号:

关键字:结节病;皮肤表现;生物疗法

年  份:2019   点击量:27

文献摘要 全文翻译

Sarcoidosis is an inflammatory disease defined by the presence of non-caseating granulomas. It can affect a number of organ systems, most commonly the lungs, lymph nodes, and skin. Cutaneous manifestations of sarcoidosis can impose a significant detriment to patients’ quality of life. The accepted first-line therapy for cutaneous sarcoidosis consists of intralesional and oral corticosteroids, but these can fail in the face of resistant disease and corticosteroid-induced adverse effects. Second-line agents include tetracyclines, hydroxychloroquine, and methotrexate. Biologics are an emerging treatment option for the management of cutaneous sarcoidosis, but their role in management is not well-defined. In this article, we reviewed the currently available English-language publications on the use of biologics in managing cutaneous sarcoidosis. Although somewhat limited, the data in published studies support the use of both infliximab and adalimumab as third-line treatments for chronic or resistant cutaneous sarcoidosis. There were also scattered reports of etanercept, rituximab, golimumab, and ustekinumab being utilized as third-line agents with varying degrees of success. Larger and more extensive investigations are required to further assess the adverse effect profile and optimal dosing for managing cutaneous sarcoidosis.

结节病是一种以非干酪性肉芽肿为特征的炎症性疾病。其可累及多个系统器官,最常累及肺、淋巴结和皮肤。结节病皮肤表现可严重损害患者生活质量。公认的皮肤结节病一线疗法包括皮损内注射和口服糖皮质激素,但因耐药性疾病和糖皮质激素引起的不良反应,这些疗法可能失败。二线药物包括四环素,羟氯喹和甲氨蝶呤。生物制剂是治疗皮肤结节病的一种新兴治疗方法,但其在治疗中的作用尚不明确。在本篇文章中,我们回顾了目前使用生物制剂治疗皮肤结节病的英文出版物。虽然有一定的局限性,但发表的研究数据支持使用英夫利昔单抗和阿达利马单抗作为慢性或难治性皮肤结节病的三线疗法。偶有报告表明依那西普,利妥昔单抗,戈利木单抗和乌司奴单抗被用作三线药物,且疗效不一。为进一步评估其治疗皮肤结节病的不良反应和最佳剂量,需要进行更广泛的调查。