甲磺酸伊马替尼致银屑病一例报道及文献复习.PDFVIP

2016 12 5 6 Chin J Colorec Dis ( Electronic Edition ) , December 2016, Vol.5, No.6 533 中华结直肠疾病电子杂志 年 月 第 卷 第 期 · · • 病例报道 • 甲磺酸伊马替尼致银屑病一例报道及文献复习 1 2 1 1 1 甄亚男 　肖瑞雪 　石会勇 　韩钢 　徐忠法 【摘要】　目的　对甲磺酸伊马替尼导致的银屑病进行系统探讨，提高临床医生的认识水平。方法 报道一例应用甲磺酸伊马替尼治疗胃肠道间质瘤诱发银屑病的患者，结合文献对其临床表现、处理原则 及其可能的发生机制进行综述。结果　口服甲磺酸伊马替尼加重或诱发银屑病多发生在服药的 3~8 周 后，临床表现多为躯干、四肢部位的皮疹，或出现银屑病甲。治疗措施多为应用糖皮质激素、紫外线 治疗或口服甲氨蝶呤，必要时停药，待皮疹控制后有望继续口服甲磺酸伊马替尼。如皮疹反复发作且 较难控制，可考虑更换第二代酪氨酸酶抑制剂。其发病机制可能与抑制 T 细胞和细胞因子相关。结论 在应用甲磺酸伊马替尼过程中，应重视银屑病的发生，一旦出现需及时对症处理并严密观察，待症状 控制后有继续恢复口服甲磺酸伊马替尼的可能，必要时更换第二代酪氨酸酶抑制剂。 【关键词】　胃肠道间质肿瘤；　甲磺酸伊马替尼；　不良反应；　银屑病 1 2 Imatinib-induced psoriasis: a case report and literature review　Zhen Yanan , Xiao Ruixue , Shi 1 1 1 1 2 Huiyong , Han Gang , Xu Zhongfa . Department of Gastrointestinal Surgery; Department of Pathology, Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan 250031, China Corresponding author: Xu Zhongfa, Email: xzfa2216@126.com; Xiao Ruixue, Email: lich3002@126.com Abstract Objective 【 】　 　To analyze imatinib-induced psoriasis systemically in order to make the clinician achieve a better comprehension. Methods　One GIST patient with imatinib-induced psoriasis was reported. Combined with the literature, the clinical manifestation, treatment principles and its possible mechanism were summarized. Results　Psoriasis aggravated or induced by imatinib often appeared in 3 to 8 weeks after taking it. Patients always developed rash on his trunk and limbs or psoriasis nail. Treatment measures include using corticosteroid and ultraviole