中国麻风皮肤病杂志 ›› 2026, Vol. 42 ›› Issue (3): 193-195.doi: 10.12144/zgmfskin202603193

• 临床研究 • 上一篇    下一篇

乌帕替尼治疗胫前黏液性水肿一例并文献复习

彭梦琪1,2,孙毅1,2   

  1. 1长江大学附属荆州医院皮肤科，湖北荆州，434020；2湖北省病原真菌感染诊疗临床医学研究中心，湖北荆州，434020
  • 出版日期:2026-03-15 发布日期:2026-03-10

Upadacitinib for the treatment of pretibial myxedema: a case report and literature review

PENG Mengqi1，2, SUN Yi1，2   

  1. 1 Department of Dermatology, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou 434020, China; 2 Hubei Provincial Clinical Research Center for Diagnosis and Therapeutics of Pathogenic Fungal Infection, Jingzhou 434020, China
  • Online:2026-03-15 Published:2026-03-10

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摘要： 胫前黏液性水肿（pretibial myxedema，PTM）是Graves病相关自身免疫性皮肤病，以真皮层黏多糖沉积、胫前水肿性斑块为特征，目前临床治疗手段有限且疗效欠佳。既往有托法替尼显著改善PTM皮损的报道，本文报道乌帕替尼治疗甲减合并PTM一例。患者，女，55岁，既往甲状腺功能减退症3年，2个多月前无明确诱因出现双小腿、双足对称性肿胀，伴局部皮肤橘皮样改变及持续性瘙痒，症状逐渐加重，诊断为PTM。予乌帕替尼口服治疗，同时优甲乐调整甲状腺功能。治疗7个月后，患者水肿完全消退，表皮瘙痒、橘皮样病变显著改善，无不良反应发生。

关键词: 胫前黏液性水肿, 乌帕替尼, Janus激酶抑制剂, Graves病

Abstract: Pretibial myxedema (PTM) is an autoimmune dermatosis associated with Graves' disease, characterized by mucopolysaccharide deposition in the dermis and edematous plaques on the anterior tibia. Clinical treatment options are limited with suboptimal efficacy. Recently, there have been reports that tofacitinib can significantly improve PTM lesions. This paper reports a case of hypothyroidism complicated with PTM treated with upadacitinib. The patient was a 55-year-old female with a 3-year history of hypothyroidism. Two months prior to admission, she presented with symmetric swelling of both lower legs and feet without definite cause, accompanied by local peau d'orange skin changes and persistent pruritus, and the symptoms gradually aggravated. She was diagnosed with PTM and treated with oral upadacitinib combined with levothyroxine for thyroid function adjustment. After 7 months of treatment, the patient's edema completely resolved, epidermal pruritus and peau d'orange lesions improved significantly, and no adverse reactions occurred.

Key words: pretibial myxedema, upadacitinib, JAK1, Graves' disease