Archive
Winter 2014, Vol. 22 No. 4
Hong Kong J. Dermatol. Venereol. (2014) 22, 169-173
Original Article
Hydroxyurea in the treatment of severe psoriasis: a retrospective review from Singapore
用羥基脲治療銀屑病：來自新加坡的回顧性分析
SY Chuah 蔡賽儀, HHB Oon 溫惠文, CTS Theng 唐添成, WS Chong 張維盛, JY Pan 潘君毅
Abstract
Introduction: Hydroxyurea is a third-line systemic agent for the treatment of psoriasis in Singapore. We aimed to evaluate the therapeutic efficacy and safety of hydroxyurea. Methods: This was a retrospective review of all psoriasis patients started on hydroxyurea at a tertiary dermatology referral centre in the National Skin Centre, Singapore from 2004-2011. Results: Forty-seven patients were included. The mean body surface area (BSA) before starting hydroxyurea was 48% (2-80%). The best mean BSA achieved was 16.5% (4-60%). Clinical improvement was reported by physicians in 32% (n=15) of the patients and no improvement in 68% (n=32) of patients. From the patient's perspective; 4% (n=2) reported an excellent effect and 32% (n=15) good effect but 42% (n=20) had no effect and 21% (n=10) had worsening of their psoriasis. The adverse effects were minimal: 34% (n=16) no adverse effects; 53% (n=25) macrocytosis and mild megaloblastic anaemia; 8.5% (n=4) thrombocytopaenia; 6% (n=3) leucopaenia and 6% (n=3) cutaneous reactions. Conclusion: Our study suggests that hydroxyurea is relatively safe and effective in some patients and can be considered as a useful alternative for those who are unable to continue other systemic agents due to adverse events or cost.
簡介：在新加坡，羥基脲是治療銀屑病的第三線系統性藥物。我們的目的是評估羥基脲的療效和安全性。方法：這一個研究，回顧了所有從二零零四到二零一一年，在新加坡一間三級皮膚病轉介中心（全國皮膚中心）的銀屑病患者使用羥基脲的情況。結果：有四十七個患者包括在內，在使用羥基脲前平均體表面積為48％（2-80％）。16.5％（4-60％）達到了最佳的平均體表面積。醫師報告有32%的患者，其臨床症狀有改善（15例），無改善的有68％（32例）。從患者的角度來看；4％（2例）有極好的效果，32％（15例）效果良好，但42％（20例）沒有影響，而21％（10例）更惡化了。不良反應甚微：34％（16例）無不良影響；53％（25例）有大紅細胞症和輕度巨幼紅細胞性貧血；8.5％（4例）有血小板減少症；6％（3例）有白細球減少症和6％（3例）有皮膚反應。結論：我們的研究發現，在部分患者，羥基脲是相對安全和有效的，並且可以被視為在那些由於不良反應或成本過高而不能繼續使用其他全身性藥物的一個有用替代品。
Keywords: Hydroxyurea, management, psoriasis
關鍵詞: 羥基脲、管理、銀屑病
