與抗IL-17A抗體相關的原發性白斑症：病例報告及文獻綜述

摘 要：

白介素 (IL)-17 抑制劑是一種經批准用於中重度銀屑病及銀屑病關節炎的生物療法。IL-17 抑制劑的常見不良事件包括注射部位反應、感染、鼻咽炎和頭痛。然而，與使用 IL-17 抑制劑相關的白斑症在既往文獻中鮮有報導。在此，我們描述了一名在接受 IL-17A 抑制劑治療銀屑病及銀屑病關節炎四個月後出現原發性白斑症的女性患者。在停用 IL-17A 抑制劑並轉用更廣泛的 T 細胞抑制劑環孢素後，我們的患者在沒有光療的情況下，銀屑病和白斑症均得到控制，並在三個月的口服環孢素治療後達到75%的再色素化。由於抗 IL-17 生物製劑在銀屑病患者中的使用越來越普遍，臨床醫生在治療前應詢問患者的白斑症病史，並告知可能的不良反應。

Interleukin (IL)-17 inhibitor is a biological therapy approved for moderate to severe psoriasis and psoriatic arthritis. The common adverse events of IL-17 inhibitor include injection site reaction, infections, nasopharyngitis, and headache. However, vitiligo associated with the use of IL-17 inhibitors was rarely reported in the previous literature. Here we described a woman who developed de novo vitiligo after 4 months of IL-17A inhibitor treatment for psoriasis and psoriatic arthritis. Upon discontinuation of IL-17A inhibitor and shifting to a broader T cell inhibitor—cyclosporine, our patient had control of both psoriasis and vitiligo and achieved 75% repigmentation after 3 months of oral cyclosporine without phototherapy. Due to the increasing use of anti-IL-17 biologics in psoriasis patients, clinicians should inquire about vitiligo’s history before treatment and inform patients of the possible adverse effects.