抗MDA5抗体阳性皮肌炎合并银屑病1例 及文献复习

Anti MDA5 Antibody Positive Dermatomyositis Complicated with Psoriasis: A Case Report and Literature Review

摘要: 皮肌炎与银屑病的发病机制均与自身免疫有关，两者并发的病例比较少见，银屑病合并抗MDA5阳性皮肌炎暂未见报道。本文主要报道1例中年男性患者，临床主要表现为全身皮疹、乏力气促。实验室结果提示肌酶升高，特发性炎性肌病谱示抗MDA5+++，左膝关节皮损病理示表皮角化过度及角化不全，小灶中性粒细胞浸润，真皮浅层小血管周围淋巴细胞浸润。右肱二头肌肌肉病理提示肌炎改变，胸部CT考虑肺间质病变可能性大。诊断为：抗MDA5阳性皮肌炎合并银屑病。关于皮肌炎合并银屑病的共同发病机制暂无确切报道，目前对于两病共存患者的治疗尚无统一意见。

Abstract: The pathogenesis of dermatomyositis and psoriasis is related to autoimmunity. The cases of concurrent dermatomyositis and psoriasis with anti-MDA5 positive dermatomyositis have not been reported. This paper mainly reports a middle-aged male patient with general rash, fatigue and shortness of breath. The laboratory results showed that the muscle enzyme increased, the spectrum of idiopathic inflammatory myopathy showed anti MDA5+++, the pathology of left knee lesions showed epidermal hyperkeratosis and dyskeratosis, small focal neutrophil infiltration, and lymphocyte infiltration around small vessels in the superficial dermis. Right biceps brachii muscle pathology suggests myositis changes, and chest CT is more likely to consider pulmonary interstitial lesions. Diagnosis: MDA5 positive dermatomyositis with psoriasis. There is no exact report on the common pathogenesis of dermatomyositis complicated with psoriasis, and there is no consensus on the treatment of the complications of the two diseases.