克拉曲滨治疗进展期播散性黄瘤3例  

Successful treatment of progressive xanthoma disseminatum with cladribine in three cases

作　　者：康莉[1] 毕志刚[1] 芦桂青[1] 刘艳[1] 富志良[1] 储小燕[1] 尹晓晴[1] 王羿婷[1] 

机构地区：[1]南京医科大学附属南京明基医院皮肤科,江苏南京210019

出　　处：《临床皮肤科杂志》2018年第2期115-119,共5页Journal of Clinical Dermatology

摘　　要：报告3例克拉曲滨成功治疗进展期播散性黄瘤(XD)。患者均为男性,2例33~34岁,1例12岁,病程5~8年。皮肤科检查:皮疹均泛发全身且伴黏膜损害,褶皱部位受累明显。2例并发尿崩症与眼内损害,3例均有黏膜受累且病情进展,对多种治疗抵抗。诊断:XD。治疗:予静脉滴注克拉曲滨0.14 mg/(kg·d),连续5 d为一个疗程,每月1次,共6个疗程。治疗后3例患者病情均有不同程度的改善,起效时间在第2~3疗程间。其中2例患者>70%皮损消退,遗留色素沉着,其余皮损明显缩小。3例黏膜和(或)眼内症状及尿崩症均明显改善。治疗过程中均未发现严重不良反应,仅有短期可逆性血细胞下降。随访4年发现停药后皮损与黏膜情况仍在进一步好转中,尿崩症亦有所好转。Three cases of progressive xanthoma disseminatum（XD） cured with cladribine are reported. Two males were 33 to 34 years old, and one male was 12 years old, with 5- to 8-year history of XD. Physical examination showed generalized rashes all over the body with mucosal damage, and lesions were more severe in the flexural regions, All patients were in progressive stage, and resistant to muhiple treatments. Two cases were complicated with diabetes insipidus and intraocular damage. All patients were diagnosed with XD. The patients were treated with intravenous eladribine at a dosage of 0.14 rag/ （kg,d） for 5 days, repeated monthly for 6 months. After 2 to 3 months of treatments, all patients showed improvement. At the end of the treatment, over 70% of lesions disappeared in two patients, No patient showed any severe adverse effects, ex- cept for hyperpigmentation and temporary, reversible hypocytosis. After termination of treatment, all patients experienced fur- ther improvements in cutaneous and mueosal damages as well as diabetes insipidus during a 4-year follow up.

关 键 词：黄瘤 播散性 克拉曲滨 

分 类 号：R593.9[医药卫生—内科学]