PDF(Pubmed)
Abstract：
Hydroxychloroquine (HCQ) is used as a traditional disease-modifying antirheumatic drugs (DMARDs), for the treatment of autoimmune diseases such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). However, it can cause serious adverse reactions, including hyperpigmentation of the skin and bull\'s-eye macular lesions. Here, we present a case of HCQ-induced hyperpigmentation of the skin and bull\'s-eye macular lesions in a patient who received HCQ for RA. A 65-year-old female patient developed blurred vision and hyperpigmentation of multiple areas of skin over the body for one month after 3 years of HCQ treatment for RA. Based on clinical presentation, ophthalmological examination and dermatopathological biopsy, a diagnosis of drug-induced cutaneous hyperpigmentation and bullous maculopathy of the right eye was made. After discontinuation of HCQ and treatment with iguratimod tablets, the hyperpigmentation of the patient \'s skin was gradually reduced, and the symptoms of blurred vision were not significantly improved. We also reviewed the available literature on HCQ-induced cutaneous hyperpigmentation and bull\'s-eye macular lesions and described the clinical features of HCQ-induced cutaneous hyperpigmentation and bull\'s-eye macular lesions. In conclusion, clinicians should be aware of early cutaneous symptoms and HCQ-associated ophthalmotoxicity in patients with rheumatic diseases on HCQ sulphate and should actively monitor patients, have them undergo regular ophthalmological examinations and give appropriate treatment to prevent exacerbation of symptoms.
摘要：
羟氯喹（HCQ）被用作传统的疾病缓解抗风湿药（DMARDs），用于治疗自身免疫性疾病，如类风湿性关节炎（RA）和系统性红斑狼疮（SLE）。然而,会引起严重的不良反应,包括皮肤色素沉着过度和牛眼黄斑病变。这里,我们介绍了1例HCQ诱导的皮肤色素沉着过度和牛眼黄斑病变的患者，该患者接受了HCQ治疗RA。一名65岁的女性患者在3年的HCQ治疗RA后一个月出现视力模糊和身体多个皮肤区域色素沉着过度。根据临床表现，眼科检查和皮肤病理活检，诊断为药物引起的皮肤色素沉着和右眼大疱性黄斑病变。停用HCQ并用艾拉莫德片治疗后，患者皮肤的色素沉着逐渐减少，视力模糊症状无明显改善。我们还回顾了有关HCQ引起的皮肤色素沉着和牛眼黄斑病变的现有文献，并描述了HCQ引起的皮肤色素沉着和牛眼黄斑病变的临床特征。总之,临床医生应注意风湿性疾病患者使用硫酸HCQ的早期皮肤症状和HCQ相关的眼毒性，并应积极监测患者，让他们接受定期眼科检查，并给予适当的治疗，以防止症状恶化。
