甲磺酸伊马替尼致银屑病一例报道及文献复习  

Imatinib-induced psoriasis:a case report and literature review

作　　者：甄亚男[1] 肖瑞雪[2] 石会勇[1] 韩钢[1] 徐忠法[1] Zhen Yanan;Xiao Ruixue;Shi Huiyong;Han Gang;Xu Zhongfa(Department of Gastrointestinal Surgery Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan 250031, China;Department of Pathology,Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan 250031, China)

机构地区：[1]山东省医学科学院附属医院外二科,250031 [2]山东省医学科学院附属医院病理科,250031

出　　处：《中华结直肠疾病电子杂志》2016年第6期533-537,共5页Chinese Journal of Colorectal Diseases(Electronic Edition)

基　　金：山东省医学科学院院级科技计划青年资助项目(No.2014-56);山东省医学科学院院级科技计划青年资助项目(No.2014-61);山东省医学科学院医药卫生科技创新工程贤助项目

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。Objective To analyze imatinib-induced psoriasis systemically in order to make theclinician achieve a better comprehension. Methods One GIST patient with imatinib-induced psoriasiswas reported. Combined with the literature, the clinical manifestation, treatment principles and its possiblemechanism were summarized. Results Psoriasis aggravated or induced by imatinib often appeared in 3 to8 weeks after taking it. Patients always developed rash on his trunk and limbs or psoriasis nail. Treatmentmeasures include using corticosteroid and ultraviolet therapy or taking methotrexate, and drug withdrawal isrequired when necessary. After the rash controlled expectedly, it was expected to continue to take imatinib.The second-generation TKIs may be considered as an alternative treatment in patients whose rash break outrepeatedly and difficult to control. Its pathogenesis may be related to the inhibition of T cells and cytokines.Conclusions The psoriasis should be seriously cared during the treatment with imatinib, the treatments forthe symptoms and the close observation should be applied in time.It is expected to continue to take imatinibuntil the symptoms are well controlled. If needed, replace the imatinib with second-generation TKIs.

关 键 词：胃肠道间质肿瘤 甲磺酸伊马替尼 不良反应 银屑病 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]