中国麻风皮肤病杂志 ›› 2026, Vol. 42 ›› Issue (9): 656-659.doi: 10.12144/zgmfskin202609656

• 病例报告 • 上一篇    下一篇

乌帕替尼治疗强直性脊柱炎合并司库奇尤单抗相关特应性皮炎一例

尹晓宇1，2，3，4,董丽萍1，2，3，4,肖风丽1，2，3，4   

  1. 1 安徽医科大学第一附属医院皮肤科，安徽合肥，230032；2 安徽医科大学皮肤病研究所，安徽合肥，230032; 3皮肤病学教育部重点实验室（安徽医科大学），安徽合肥，230032；4 疑难重症皮肤病协同创新中心，安徽医科大学，安徽合肥，230032
  • 出版日期:2026-09-15 发布日期:2026-09-02

Upadacitinib for ankylosing spondylitis complicated with secukinumab-associated atopic dermatitis: a case report

YIN Xiaoyu1，2，3，4, DONG Liping1，2，3，4, XIAO Fengli1，2，3，4   

  1. 1 Department of Dermatology, The First Affiliated Hospital, Anhui Medical University, Hefei 230032, China; 2 Institute of Dermatology, Anhui Medical University, Hefei 230032, China; 3 Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei 230032, China; 4 Collaborative Innovation Center of Complex and Severe Skin Disease, Anhui Medical University, Hefei 230032, China
  • Online:2026-09-15 Published:2026-09-02

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摘要： 强直性脊柱炎以Th17型免疫反应为主，靶向IL-17A的司库奇尤单抗是常用治疗药物，但该类药物可能引发免疫漂移，诱发以Th2炎症为主的特应性皮炎。本文报道1例54岁女性强直性脊柱炎患者，规律使用司库奇尤单抗治疗后关节症状好转，但周身出现泛发瘙痒性红斑丘疹，结合实验室检查、皮损病理及临床表现确诊为重度特应性皮炎，停用原药并予外用药物及抗组胺治疗无效后，改用选择性JAK1抑制剂乌帕替尼治疗，用药2个月后患者皮疹、瘙痒及腰背疼痛、骶髂关节压痛均显著缓解，随访6个月病情持续稳定且未出现明显不良反应。

关键词: 特应性皮炎, 强直性脊柱炎, 乌帕替尼, 免疫漂移

Abstract: Ankylosing spondylitis is predominantly driven by Th17-type immune responses. Secukinumab, a targeted agent against IL-17A, is a commonly used therapeutic drug for this condition. However, such agents may induce immune drift and trigger atopic dermatitis mediated mainly by Th2 inflammation. This article reports a 54-year-old female patient with ankylosing spondylitis. After regular treatment with secukinumab, her articular symptoms improved, yet generalized pruritic erythema and papules developed all over the body. Combined with laboratory examinations, skin lesion pathology and clinical manifestations, the patient was diagnosed with severe atopic dermatitis. Discontinuation of secukinumab plus topical medications and antihistamines failed to relieve symptoms. The patient was then switched to upadacitinib, a selective JAK1 inhibitor. Two months after treatment initiation, her skin rashes, pruritus, lumbodorsal pain and sacroiliac joint tenderness were markedly alleviated. The patient remained in stable condition without obvious adverse reactions during the 6-month follow-up.

Key words: atopic dermatitis, ankylosing spondylitis, upadacitinib, immune drift