■红皮银屑病(EP)的治疗仍然具有挑战性,因为它很少见并且具有复杂的并发症。虽然阿维A被推荐作为EP的合适选择,缺乏大规模证据。
■本研究旨在评估阿维A在EP患者中作为全身性单一疗法的疗效和安全性。
我们回顾性分析了2005年1月至2021年5月在北京协和医院住院和门诊随访期间接受至少3个月阿维A作为全身单一疗法的EP患者的数据。中国。
■在治疗1、2、4和12周后对疗效进行临床评估,这被归类为良好的反应(>75%的病变清除),部分响应(50%-75%清除),中等反应(25-50%清除),或无响应(清除<25%)。在治疗12周后,根据体检结果和实验室检查结果的显着变化评估安全性。
■总的来说,81名患者(79.0%男性;平均年龄,包括47.9年)。阿维A的剂量范围为20至60mg/天(0.3至0.8mg/kg/天)。良好的比率,局部,中度反应为0.0%,2.5%,1周时为42.0%;3.7%,34.6%,2周时为61.7%;29.6%,58.0%,4周时为12.4%;85.2%,13.6%,治疗开始后12周为1.2%,分别。与从脓疱或关节型银屑病发展的EP患者相比,从寻常型银屑病转化的EP患者显示出更高的良好/部分缓解率(44.6%vs.14.3%,p=0.035)。与没有并发感染的患者相比,并发感染的患者表现出更低的良好/部分反应率(16.7%vs.44.4%,p=0.049)。在12周内,45例(55.6%)患者出现不良反应,和血脂异常(n=31;38.3%),干燥症(n=24;29.6%),和升高的肝酶(n=6;7.4%)是最常见的报道。23例患者随访3年以上,6例(26.1%)患者发生EP复发。
■阿曲汀作为全身性单一疗法对EP显示出令人满意的疗效,特别是在患有寻常型银屑病且没有感染的患者中。
UNASSIGNED: Erythrodermic psoriasis (EP) remains challenging to manage because it is rare and has complex complications. Although
acitretin is recommended as an appropriate choice for EP, there is a lack of large-scale evidence.
UNASSIGNED: This study aims to assess the efficacy and safety of
acitretin as systemic monotherapy in EP patients.
UNASSIGNED: We retrospectively analyzed data from patients with EP who received at least 3 months of acitretin as systemic monotherapy during hospitalization and out-patient follow-up from January 2005 to May 2021 at the Peking Union Medical College Hospital,
China.
UNASSIGNED: The efficacy was clinically evaluated after 1, 2, 4, and 12 weeks of treatment, which was classified as a good response (>75% of lesions cleared), partial response (50%-75% cleared), moderate response (25-50% cleared), or no response (<25% cleared). Safety was assessed on the basis of physical examination results and significant changes in laboratory examination results after 12 weeks of treatment.
UNASSIGNED: Overall, 81 patients (79.0% men; mean age, 47.9 years) were included. The
acitretin dose ranged from 20 to 60 mg/day (0.3 to 0.8 mg/kg/day). The rates of good, partial, and moderate responses were 0.0%, 2.5%, and 42.0% at 1 week; 3.7%, 34.6%, and 61.7% at 2 weeks; 29.6%, 58.0%, and 12.4% at 4 weeks; and 85.2%, 13.6%, and 1.2% at 12 weeks after treatment initiation, respectively. EP patients transformed from psoriasis vulgaris showed a higher good/partial response rate compared with that of EP patients that developed from pustular or articular psoriasis (44.6% vs. 14.3%, p = 0.035). Patients with concurrent infection showed a lower rate of good/partial response compared with that of those without concurrent infection (16.7% vs. 44.4%, p = 0.049). Adverse effects were seen in 45 (55.6%) patients in 12 weeks, and dyslipidemia (n = 31; 38.3%), xerosis (n = 24; 29.6%), and elevated liver enzymes (n = 6; 7.4%) were most commonly reported. Twenty-three patients were followed up for over 3 years, and six (26.1%) patients had EP recurrence.
UNASSIGNED: Acitretin as a systemic monotherapy showed satisfactory effectiveness for EP, especially in patients developed from psoriasis vulgaris and without infection.