外用磷酸二酯酶4抑制剂软膏治疗斑秃一例附文献复习

斑秃既往治疗包括局部外用药物治疗(糖皮质激素、米诺地尔等)、系统药物治疗(口服糖皮质激素、甲氨蝶呤、环孢素等)以及物理疗法(如光化学疗法PUVA、308 nm准分子激光等)。磷酸二酯酶4(PDE-4)抑制剂通过增加细胞内环磷酸腺苷(cAMP)水平,进而调节一系列细胞因子发挥免疫调节作用。国外曾有口服PDE-4抑制剂治疗斑秃的动物模型研究和病例报道,但存在较多的不良反应。克立硼罗软膏是近年来新研发的外用磷酸二酯酶4(PDE-4)抑制剂,曾报道用于特应性皮炎、银屑病和白癜风等皮肤病的治疗,其治疗斑秃的二期临床试验正在开展,目前国内外尚无治疗斑秃的正式报道。我们报道一例外用磷酸二酯酶4抑制剂治疗斑秃的患者,取得良好治疗效果,未见明显不良反应。

Topical phosphodiesterase-4 inhibitor in the treatment of alopecia areata: a case report and literature review

The common therapies of alopecia areata (AA) include topical medications (corticosteroid, minoxidil, etc.), systemic medications (oral corticosteroid, methotrexate, cyclosporine, etc.) and physiotherapy (e.g. photochemical therapy PUVA, 308-nm excimer laser, etc.). Phosphodiesterase-4 (PDE-4) inhibitors regulate a range of cytokines by increasing intracellular cyclic adenosine monophosphate (cAMP) levels. Previous animal model studies and a series of case reports have shown that oral PDE-4 inhibitors can treat baldness, but there are more adverse side effects. Crisaborole ointment is a kind of phosphodiesterase-4 (PDE-4) inhibitors, which have been reported in the treatment of atopic dermatitis, psoriasis and vitiligo. Phase 2 clinical trial of criborol ointment in the treatment of alopecia areata is under way, and there is no report about criborol ointment on the treatment of alopecia areata at home and abroad. We recently admitted to a patient who was treated with PDE-4 inhibitors for alopecia areata successfully, with no obvious adverse reaction.