Yanjie Wei,1,* Peilian Zhang,2,* Jintao Chuan,1 Jianzhou Ye,2 Tao Liu3 

1Department of Dermatology, The First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine, Kunming, People’s Republic of China; 2Department of Dermatology, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, Yunnan, People’s Republic of China; 3Department of Pathology, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, Yunnan, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Peilian Zhang, Department of Dermatology, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, People’s Republic of China, Email mzczpl1968@163.com
摘要： 

目的：本报告旨在介绍一例罕见的反常反应表现为白塞氏病样的特征，在接受司库奇尤单抗治疗银屑病 3 个月后出现的不良反应。

患者与方法：一名38岁女性患者，有近30年的银屑病病史。该患者在接受七剂司库奇尤单抗治疗后(总剂量为2100mg)，银屑病病情明显改善。然而，她出现了咽喉疼痛、扁桃体及外生殖器疼痛性溃疡，躯干、四肢毛囊炎样丘疹以及双下肢伸侧结节性红斑皮损等不良反应。实验室检查未发现感染证据，皮肤活检的组织病理学示浅层和深层血管周围及间质炎症，伴有大量淋巴细胞、中性粒细胞和嗜酸性粒细胞浸润，该患者被诊断为司库奇尤单抗诱发的类似白塞氏病。立即停用司库奇尤单抗，给予沙利度胺 50mg 每日三次；秋水仙碱 50mg每日两次治疗。

结果：治疗两周后，口腔及外生殖器溃疡消退，躯干、四肢毛囊炎样丘疹、结节性红斑好转，仅留下色素沉着。后改用乌司奴单抗标准剂量规律治疗，银屑病控制佳，随访4年，未见白塞病样皮疹复发。