双靶向联合治疗白细胞介素-17A抑制剂失效的银屑病  

Dual-targeted combination therapy for psoriasis with 1L-17A inhibitor failure

作　　者：崔寅玲 曹珊 薛晓彤 赵晴 周桂芝[1] 刘红[1] 张福仁[1] CUI Yinling;CAO Shan;XUE Xiaotong;ZHAO Qing;ZHOU Guizhi;LIU Hong;ZHANG Furen(Department of Dermatology,Hospital for Skin Diseases,Shandong First Medical University,Shandong Provincial Institute of Dermatology and Venereology,Shandong Academy of Medical Sciences,Jinan 250022,China)

机构地区：[1]山东第一医科大学附属皮肤病医院、山东省皮肤病性病防治研究所皮肤科,山东济南250022

出　　处：《临床皮肤科杂志》2025年第4期234-235,共2页Journal of Clinical Dermatology

摘　　要：报告1例应用双靶向联合治疗的对白细胞介素-17A抑制剂失效的银屑病患者。患者男,35岁。全身红斑和鳞屑17年,加重2年。皮肤科检查:头皮、躯干和四肢弥漫分布红斑片,覆白色鳞屑。Auspitz征阳性。诊断:银屑病。治疗:患者曾成功使用IL-17A抑制剂司库奇尤单抗和依奇珠单抗治疗,实现皮损清零。然而,在维持期间患者病情复发。再次应用IL-17A抑制剂后,病情未改善。评估病情后,患者使用司库奇尤单抗和乌帕替尼的双靶向联合治疗方案使病情达成平稳过渡,成功转换为口服乌帕替尼治疗。This manuscript presents a case involving the application of dual-targeted combination therapy for a patient with psoriasis,where the initial treatment with an interleukin-17A(IL-17A)inhibitor had proven ineffective.The patient was a 35-year-old male who had a 17-year history of generalized erythematous scaling on the skin,with the condition exacerbating over the past 2 years.Upon dermatological assessment,there were noted diffusely scattered erythematous plaques adorned with white scales across the scalp,trunk and extremities.The Auspitz sign was positive.Based on the clinical manifestations and examination findings,the diagnosis of psoriasis was established.The patient achieved complete clearance of cutaneous lesions following successful treatment with the IL-17A inhibitors,secukinumab and ixekizumab.Regrettably,a disease relapse occurred during the maintenance phase.After the re-administration of the IL-17A inhibitor,the patient's condition did not exhibit any signs of improvement.After evaluating the patient's condition,a combination regimen of secukinumab and upadacitinib was adopted.This combinatorial approach facilitated a seamless transition in the patient's treatment paradigm,ultimately leading to the patient being switched to oral upadacitinib monotherapy.

关 键 词：双靶向联合治疗 乌帕替尼 银屑病 白细胞介素-17A抑制剂 Janus激酶抑制剂 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]