A Rare Case of New-Onset Crohn's Disease in a Patient With Chronic Palmoplantar Pustulosis.

Satoshi Tanida, Shoichiro Yoshii, Ryoji Kubo, Takuya Takahama, Shun Sasoh, Yoshimasa Kubota, Tesshin Ban, Tomoaki Ando, Makoto Nakamura, Takashi Joh
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Abstract

A 44-year-old woman who had been diagnosed with palmoplantar pustulosis (PPP) at 34 years old was diagnosed with moderate Crohn's disease (CD) based on endoscopic, radiological, and pathological findings. As treatment with corticosteroids, ultraviolet, and cyclosporin had achieved partial response, PPP had been refractory in a chronic continuous state. Oral prednisolone was initially started to treat CD, but clinical remission was not achieved. Intravenous ustekinumab was subsequently started at 260 mg for clinical remission of CD. Eight weeks after starting ustekinumab, clinical remission and mucosal healing were achieved and PPP manifestations on the palms and soles were markedly improved. Ustekinumab appears to offer an effective therapeutic option for patients with PPP but has yet to be approved for this induction in Japan. CD is a rare gastrointestinal involvement in PPP patients that requires attention.

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慢性掌足底脓疱病新发克罗恩病1例罕见。
一名44岁女性,34岁时被诊断为掌跖脓疱病(PPP),经内窥镜、放射学和病理检查诊断为中度克罗恩病(CD)。由于皮质类固醇、紫外线和环孢素治疗已取得部分缓解,PPP在慢性持续状态下是难治性的。口服强的松龙最初开始治疗乳糜泻,但没有达到临床缓解。随后开始静脉注射ustekinumab 260 mg用于临床缓解CD。开始ustekinumab 8周后,临床缓解和粘膜愈合,手掌和鞋底的PPP表现明显改善。Ustekinumab似乎为PPP患者提供了一种有效的治疗选择,但尚未在日本获得批准。乳糜泻是PPP患者中罕见的胃肠道病变,需要引起注意。
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