抗 TNF-α 抑制剂
此外,由于发现发热溃疡坏死性苔藓样糠疹患者的血清 TNF-α和全身的 T 细胞活性较高,将来 TNF-α 抑制剂可能成为治疗苔藓样糠疹的一种方法。[23]Tsianakas A, Hoeger PH. Transition of pityriasis lichenoides et varioliformis acuta to febrile ulceronecrotic Mucha-Habermann disease is associated with elevated serum tumor necrosis factor-alpha. Br J Dermatol. 2005 Apr;152(4):794-9.http://www.ncbi.nlm.nih.gov/pubmed/15840118?tool=bestpractice.com 依那西普已经用于另一类型的丘疹鳞屑性炎症性皮肤病:银屑病。[1]Khachemoune A, Blyumin ML. Pityriasis lichenoides: pathophysiology, classification, and treatment review. Am J Clin Dermatol. 2007;8(1):29-36.http://www.ncbi.nlm.nih.gov/pubmed/17298104?tool=bestpractice.com 依那西普在患有类风湿关节炎和克罗恩病的儿童和成人患者中表现出良好的安全性,因此应作为难治性苔藓样糠疹的替代疗法。[1]Khachemoune A, Blyumin ML. Pityriasis lichenoides: pathophysiology, classification, and treatment review. Am J Clin Dermatol. 2007;8(1):29-36.http://www.ncbi.nlm.nih.gov/pubmed/17298104?tool=bestpractice.com 另有一份报告描述了使用依那西普治疗苔藓样糠疹的情况。[25]Nikkels AF, Gillard P, Piérard GE. Etanercept in therapy multiresistant overlapping pityriasis lichenoides. J Drugs Dermatol. 2008 Oct;7(10):990-2.http://www.ncbi.nlm.nih.gov/pubmed/19112768?tool=bestpractice.com 抗 TNF-α 抑制剂用于治疗苔藓样糠疹尚未获得食品药品监督管理局 (FDA) 的批准。 应谨慎使用这些治疗方法,尽管已有使用生物制剂(英夫利昔单抗和阿达木单抗)治疗苔藓样糠疹患者的报道。[26]Said BB, Kanitakis J, Graber I, et al. Pityriasis lichenoides chronica induced by adalimumab therapy for Crohn's disease: report of 2 cases successfully treated with methotrexate. Inflamm Bowel Dis. 2010 Jun;16(6):912-3.http://www.ncbi.nlm.nih.gov/pubmed/19821511?tool=bestpractice.com[27]López-Ferrer A, Puig L, Moreno G, et al. Pityriasis lichenoides chronica induced by infliximab, with response to methotrexate. Eur J Dermatol. 2010 Jul-Aug;20(4):511-2.http://www.ncbi.nlm.nih.gov/pubmed/20395191?tool=bestpractice.com
光动力疗法和菠萝蛋白酶
最近的病例报告指出,使用光动力疗法和菠萝蛋白酶治疗苔藓样糠疹患者有一定的效果。[28]Fernández-Guarino M, Harto A, Reguero-Callejas ME, et al. Pityriasis lichenoides chronica: good response to photodynamic therapy. Br J Dermatol. 2008 Jan;158(1):198-200.http://www.ncbi.nlm.nih.gov/pubmed/18028490?tool=bestpractice.com[29]Massimiliano R, Pietro R, Paolo S, et al. Role of bromelain in the treatment of patients with pityriasis lichenoides chronica. J Dermatolog Treat. 2007;18(4):219-22.http://www.ncbi.nlm.nih.gov/pubmed/17671882?tool=bestpractice.com