rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2009-146rsp-481Research ArticleСтатьиArticlesСерьезная кожная реакция, индуцированная лефлуномидом, у больного ювенильнымхроническим артритомSerious skin reaction induced by leflunomide in a patient with juvenilechronic arthritisMuravjovY VMuravjovY V-MuravjovaN VMuravjovaN V-200915022009471№1 (2009)8386Copyright © Muravjov Y.V., Muravjova N.V., 20092009Muravjov Y.V., Muravjova N.V.Muravjov Y.V., Muravjova N.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/481

Представлено описание серьезной кожной реакции, вызванной лефлуномидом, у больного ювенильным хроническим артритом. Дан литературный обзор индуцированных лефлуномидом кожных реакций. Обсуждены рекомендации по назначению лефлуномида.

A case of an adverse skin reaction to leflunomide in a pt with juvenile chronic arthri- tis is described. Literature review of leflunomide induced skin reactions is presented. Leflunomide administration guidelines are discussed.

лефлуномиднеблагоприятная реакциякожная реакцияleflunomideadverse eventskin reactionReferences<div><p>Балабанова Р.М., Маколкин В.И., Шостак Н.А, и др. Динамика показателей воспалительной активности у больных ревматоидным артритом на ранних этапах базисной терапии лефлюномидом. Тер. архив, 2004, 5, 21-5.</p><p>Ревматология: национальное руководство. Под ред. Е.Л. Насонова, В.А. Насоновой. М., ГЕОТАР-Медиа, 2008, 720 с.</p><p>Чичасова Н.В., Бродецкая К.А., Иголкина Е.В. Опыт применения лефлуномида (препарата АРАВА) у больных активным ревматоидным артритом. РМЖ, 2005, 13 (8), 518–24.</p><p>Breedveld F.C., Dayer J-M. Leflunomide mode of action in the treatment of rheumatoid arthritis. Ann. Rheum.Dis., 2000, 59, 841-9.</p><p>Chan A.T., Bradlow A., McNally J. Leflunomide induced vasculitis – a dose-response relationship. Rheumatology (Oxford), 2002, 41, 116-7.</p><p>Cohen S., Cannon G., Schiff M. et al. Two-year, blinded, randomized, controlled trial of treatment of active rheumatoid arthritis with leflunomide compared with methotrexate. Utilisation of leflunomide in the treatment of Rheumatoid Arthritis Investigator Group. Arthritis Rheum., 2001, 44, 1984-92.</p><p>Elias A.R., Tam C.C., David-Bajar K.M. Subacute cutaneous lupus erythematosus associated with leflunomide. Cutis, 2005, 76 (3), 189-92.</p><p>Еmery P., Breedveld F.C., Lemmel E.M. et al. A comparison of the efficacy and safety of leflunomide and methotrexate for the treatment of rheumatoid arthritis. Rheumatology (Oxford), 2000, 39, 655-65.</p><p>Fischer T.W., Bauer H.I., Graefe T. et al. Erythema multiforme-like drug eruption with oral involvement after intake of leflunomide. Dermatology, 2003, 207 (4), 386-9.</p><p>Fox R.I., Herrman M.L., Frangou C.G. et al. Mechanism of action for leflunomide in rheumatoid arthritis.Clin.Immunol., 1999, 93, 198-208.</p><p>Gensburger D., Kawashima M., Marotte H. et al. Lupus erythematosus with leflunomide: induction or reactivation? Ann. Rheum. Dis., 2005, 64 (1), 153-5.</p><p>Gros C., Delesalle F., Gautier S., Delaporte E. Leflunomide-induced skin necrosis. Ann. Dermatol. Venereol., 2008, 135 (3), 205-8.</p><p>Hassikou H., El Haouri M., Tabache F. et al. Leflunomide-induced toxic epidermal necrolysis in a patient with rheumatoid arthritis. Joint Bone Spine, 2008, Sep 19 [Pub ahead of print].</p><p>Jakob A., Porstmann R., Rompel R. Skin ulceration after leflunomide treatment in two patients with rheumatoid arthritis. J. Dtsch. Dermatol. Ges., 2006, 4 (4), 324-7.</p><p>Jian X., Guo G., Ruan Y. et al. Severe cutaneous adverse drug reaction to leflunomide: a report of two cases. Cutan. Ocul. Toxicol., 2008, 27 (1), 5-9.</p><p>Kalden J.R., Scott D.L., Smolen J.S. et al. Improved functional ability in patients with rheumatoid arthritis – long-term treatment with leflunomide versus sulfasalazine. European Leflunomide Study Group. J. Rheumatol., 2001, 28, 1983-91.</p><p>Marzano A.V., Ramoni S., Del Papa N. et al. Leflunomide-induced subacute cutaneous lupus erythematosus with erythema multiforme-like lesions. Lupus, 2008, 17(4), 329-31.</p><p>McCoy C.M. Leflunomide-associated skin ulceration. Ann. Pharmacother., 2002, 36 (6), 1009-11.</p><p>Olsen N.J., Stein C.M. New drugs for rheumatoid arthritis. New Engl. J. Med., 2004, 350, 2167-79.</p><p>Scott D.L., Smolen J.S., Kalden J.R. et al. Treatment of active rheumatoid arthritis with leflunomide, two year follow up of a double-blind, placebo controlled trial versus sulfasalasine. Ann. Rheum. Dis., 2001, 60, 913-23.</p><p>Shastri V., Betkerur J., Kushalappa P.A. et al. Severe cutaneous adverse drug reaction to leflunomide: a report of five cases. Indian J. Dermatol. Venereol. Leprol., 2006, 72, 286-9.</p><p>Smolen J.S., Kalden J.R., Scott D.L. et al. Efficacy and safety of leflunomide compared with placebo and sulphasalazine in active rheumatoid arthritis: a double-blind, randomised, multi-centre trial. Lancet, 1999, 353, 259-66.</p><p>Soliotis F., Glover M., Jawad A.S. Severe skin reac- tion after leflunomide and etanercept in a patient with rheumatoid arthritis. Ann. Rheum. Dis., 2002, 61 (9), 850-1.</p><p>Strand V., Cohen S., Schiff M. et al. Treatment of active rheumatoid arthritis with leflunomide compared to placebo and methotrex- ate. Arch. Intern. Med., 1999,159,2542-50.</p><p>Suess A., Sticherling M. Leflunomide in subacute cutaneous lupus erythematosus – two sides of a coin. Int. J. Dermatol., 2008, 47 (1), 83-6.</p></div><br /><div><p>Балабанова Р.М., Маколкин В.И., Шостак Н.А, и др. Динамика показателей воспалительной активности у больных ревматоидным артритом на ранних этапах базисной терапии лефлюномидом. Тер. архив, 2004, 5, 21-5.</p><p>Ревматология: национальное руководство. Под ред. Е.Л. Насонова, В.А. Насоновой. М., ГЕОТАР-Медиа, 2008, 720 с.</p><p>Чичасова Н.В., Бродецкая К.А., Иголкина Е.В. Опыт применения лефлуномида (препарата АРАВА) у больных активным ревматоидным артритом. РМЖ, 2005, 13 (8), 518–24.</p><p>Breedveld F.C., Dayer J-M. Leflunomide mode of action in the treatment of rheumatoid arthritis. Ann. Rheum.Dis., 2000, 59, 841-9.</p><p>Chan A.T., Bradlow A., McNally J. Leflunomide induced vasculitis – a dose-response relationship. Rheumatology (Oxford), 2002, 41, 116-7.</p><p>Cohen S., Cannon G., Schiff M. et al. Two-year, blinded, randomized, controlled trial of treatment of active rheumatoid arthritis with leflunomide compared with methotrexate. Utilisation of leflunomide in the treatment of Rheumatoid Arthritis Investigator Group. Arthritis Rheum., 2001, 44, 1984-92.</p><p>Elias A.R., Tam C.C., David-Bajar K.M. Subacute cutaneous lupus erythematosus associated with leflunomide. Cutis, 2005, 76 (3), 189-92.</p><p>Еmery P., Breedveld F.C., Lemmel E.M. et al. A comparison of the efficacy and safety of leflunomide and methotrexate for the treatment of rheumatoid arthritis. Rheumatology (Oxford), 2000, 39, 655-65.</p><p>Fischer T.W., Bauer H.I., Graefe T. et al. Erythema multiforme-like drug eruption with oral involvement after intake of leflunomide. Dermatology, 2003, 207 (4), 386-9.</p><p>Fox R.I., Herrman M.L., Frangou C.G. et al. Mechanism of action for leflunomide in rheumatoid arthritis.Clin.Immunol., 1999, 93, 198-208.</p><p>Gensburger D., Kawashima M., Marotte H. et al. Lupus erythematosus with leflunomide: induction or reactivation? Ann. Rheum. Dis., 2005, 64 (1), 153-5.</p><p>Gros C., Delesalle F., Gautier S., Delaporte E. Leflunomide-induced skin necrosis. Ann. Dermatol. Venereol., 2008, 135 (3), 205-8.</p><p>Hassikou H., El Haouri M., Tabache F. et al. Leflunomide-induced toxic epidermal necrolysis in a patient with rheumatoid arthritis. Joint Bone Spine, 2008, Sep 19 [Pub ahead of print].</p><p>Jakob A., Porstmann R., Rompel R. Skin ulceration after leflunomide treatment in two patients with rheumatoid arthritis. J. Dtsch. Dermatol. Ges., 2006, 4 (4), 324-7.</p><p>Jian X., Guo G., Ruan Y. et al. Severe cutaneous adverse drug reaction to leflunomide: a report of two cases. Cutan. Ocul. Toxicol., 2008, 27 (1), 5-9.</p><p>Kalden J.R., Scott D.L., Smolen J.S. et al. Improved functional ability in patients with rheumatoid arthritis – long-term treatment with leflunomide versus sulfasalazine. European Leflunomide Study Group. J. Rheumatol., 2001, 28, 1983-91.</p><p>Marzano A.V., Ramoni S., Del Papa N. et al. Leflunomide-induced subacute cutaneous lupus erythematosus with erythema multiforme-like lesions. Lupus, 2008, 17(4), 329-31.</p><p>McCoy C.M. Leflunomide-associated skin ulceration. Ann. Pharmacother., 2002, 36 (6), 1009-11.</p><p>Olsen N.J., Stein C.M. New drugs for rheumatoid arthritis. New Engl. J. Med., 2004, 350, 2167-79.</p><p>Scott D.L., Smolen J.S., Kalden J.R. et al. Treatment of active rheumatoid arthritis with leflunomide, two year follow up of a double-blind, placebo controlled trial versus sulfasalasine. Ann. Rheum. Dis., 2001, 60, 913-23.</p><p>Shastri V., Betkerur J., Kushalappa P.A. et al. Severe cutaneous adverse drug reaction to leflunomide: a report of five cases. Indian J. Dermatol. Venereol. Leprol., 2006, 72, 286-9.</p><p>Smolen J.S., Kalden J.R., Scott D.L. et al. Efficacy and safety of leflunomide compared with placebo and sulphasalazine in active rheumatoid arthritis: a double-blind, randomised, multi-centre trial. Lancet, 1999, 353, 259-66.</p><p>Soliotis F., Glover M., Jawad A.S. Severe skin reac- tion after leflunomide and etanercept in a patient with rheumatoid arthritis. Ann. Rheum. Dis., 2002, 61 (9), 850-1.</p><p>Strand V., Cohen S., Schiff M. et al. Treatment of active rheumatoid arthritis with leflunomide compared to placebo and methotrex- ate. Arch. Intern. Med., 1999,159,2542-50.</p><p>Suess A., Sticherling M. Leflunomide in subacute cutaneous lupus erythematosus – two sides of a coin. Int. J. Dermatol., 2008, 47 (1), 83-6.</p></div><br />

The authors declare that there are no conflicts of interest present.