司库奇尤单抗治疗13例难治性局限性脓疱型银屑病的临床疗效与安全性观察  

Clinical efficacy and safety of secukinumab in the treatment of 13 cases of refractory localized pustular psoriasis

作　　者：周健[1] 俞晨[1] 王刚[1] Zhou Jian;Yu Chen;Wang Gang(Department of Dermatology,Xijing Hospital,The Fourth Military Medical University,Xi′an 710032,China)

机构地区：[1]第四军医大学西京皮肤医院,西安710032

出　　处：《中华皮肤科杂志》2023年第3期247-251,共5页Chinese Journal of Dermatology

基　　金：国家自然科学基金(82003342);陕西省重点研发计划项目(2022ZDLSF03-14)。

摘　　要：目的观察司库奇尤单抗对常规治疗无效或不耐受的难治性局限性脓疱型银屑病的临床疗效和安全性。方法收集并分析2019年12月至2022年4月于西京皮肤医院门诊接受司库奇尤单抗治疗的13例难治性局限性脓疱型银屑病患者的资料,评价掌跖脓疱病(PPP)患者治疗前后PPP皮损面积和严重程度指数(PPPASI)评分、临床医师整体评估(PGA)评分,评价连续性肢端皮炎(ACH)患者临床疗效总体量表(CGI)评分,记录治疗期间不良事件发生情况。结果13例难治性局限性脓疱型银屑病患者中,PPP 6例,ACH 3例,PPP合并ACH 4例。男3例,女10例,年龄(33.2±14.6)岁。治疗12周时,存在PPP表现的10例患者PPPASI评分由基线(13.88±3.62)分降至(6.81±2.31)分,4例达到PPPASI75,5例达到PGA0/1;存在ACH表现的7例患者中6例CGI评分达到中度改善以上,4例达到显著改善。2例PPP患者因应答不佳分别于治疗3周、5周停药,1例ACH患者治疗12周CGI评分为轻度改善。随访期间未发生严重不良事件,出现毛囊性炎性丘疹、湿疹样皮损各1例,予以对症治疗后缓解。结论司库奇尤单抗治疗局限性脓疱型银屑病安全有效,可作为难治性PPP和ACH的治疗新选择。Objective To evaluate clinical efficacy and safety of secukinumab in the treatment of patients with localized pustular psoriasis irresponsive or intolerant to conventional treatment.Methods Clinical data were collected from 13 patients with refractory localized pustular psoriasis,who received secukinumab treatment in Department of Dermatology,Xijing Hospital from December 2019 to April 2022.Efficacy was evaluated by comparing palmoplantar pustulosis(PPP)area and severity index(PPPASI)score and physician global assessment(PGA)score in PPP patients before and after the treatment,and by comparing clinical global impression(CGI)score in patients with acrodermatitis continua of Hallopeau(ACH).Adverse events were recorded during the treatment.Results Among the 13 patients with refractory localized pustular psoriasis,6 were diagnosed with PPP,3 with ACH,and 4 with PPP complicated by ACH.There were 3 males and 10 females,and their age was 33.2±14.6 years.After 12-week treatment,the PPPASI score decreased from 13.88±3.62 points at baseline to 6.81±2.31 points in 10 patients presenting with PPP lesions,4 achieved 75%improvement in the PPPASI score(PPPASI75),and 5 achieved PGA0/1;at the same time,6 of the 7 patients presenting with ACH lesions achieved moderate or marked improvement in the CGI score,and 4 of the 6 patients achieved marked improvement.Two patients with PPP discontinued the treatment after 3-and 5-week treatment respectively due to poor response,and 1 patient with ACH achieved mild improvement in the CGI score after 12-week treatment.No severe adverse events were reported during the treatment.However,inflammatory follicular papules occurred in 1 patient,and eczematoid lesions occurred in another 1 patient,which both regressed after symptomatic treatment.Conclusion Secukinumab was effective and safe in the treatment of refractory localized pustular psoriasis,and may serve as a new treatment option for refractory PPP and ACH.

关 键 词：银屑病 生物制剂 治疗结果 掌跖脓疱病 连续性肢端皮炎 司库奇尤单抗 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]