PDF(Pubmed)
Abstract：
Pityriasis rubra pilaris (PRP) is a rare inflammatory skin disorder characterized by hyperkeratotic follicular papules, orange-red scaling plaques with islands of sparing and palmoplantar keratoderma. While spontaneous resolution occurs in some cases, treatment can be challenging for others. The use of biologics in PRP management has gained attention in recent studies, although their high costs and potential side effects present limitations. We present a case of a 71-year-old patient with treatment-resistant PRP who showed significant improvement through optimized adalimumab treatment. Considering the emerging role of phospholipase A2 in PRP pathogenesis, montelukast was added, further enhancing the therapeutic response. By maintaining montelukast and prolonging the adalimumab interval to 3 and 4 weeks, effective dose optimization was achieved without PRP relapse. This case report highlights the potential for adalimumab dose optimization by shortening the initial treatment interval for increased effectiveness and lengthening the interval during the maintenance phase to conserve medication doses. Montelukast appears to assist in sustaining clinical outcomes during interval prolongation, necessitating further investigation through additional studies.
摘要：
毛发红斑糠疹（PRP）是一种罕见的炎症性皮肤病，其特征是角化过度的毛囊丘疹，橙红色鳞屑斑块，有保留岛和掌足底角化症。虽然在某些情况下发生自发消退，治疗对其他人来说可能是具有挑战性的。生物制剂在PRP管理中的使用在最近的研究中得到了关注，尽管它们的高成本和潜在的副作用存在局限性。我们介绍了一例71岁的治疗耐药PRP患者，通过优化的阿达木单抗治疗显示出显着改善。考虑到磷脂酶A2在PRP发病机制中的新作用，添加了孟鲁司特，进一步增强治疗反应。通过维持孟鲁司特并将阿达木单抗间隔延长至3周和4周，实现了有效剂量优化,且PRP无复发.该病例报告强调了阿达木单抗剂量优化的潜力，通过缩短初始治疗间隔以提高疗效，并在维持阶段延长间隔以节省药物剂量。孟鲁司特似乎有助于在间期延长期间维持临床结果，需要通过其他研究进行进一步调查。
