Abstract
Felty's syndrome is an uncommon condition characterized by the combination of rheumatoid arthritis (RA), splenomegaly, and neutropenia. Disease-modifying anti-rheumatic drugs and biologic agents have been used to treat early RA to achieve remission. Anti-tumor necrosis factor $(TNF)-{\alpha}$ agents are effective for controlling the disease; however, some studies have suggested the possibility of adverse effects such as increased frequency of infection or malignancy. Bowen's disease, known as squamous cell carcinoma in situ, is a skin cancer that can be caused by sun exposure, arsenic ingestion, human papilloma virus, skin damage, and prolonged immunosuppression. We report the case of a 64-year-old female diagnosed with Bowen's disease during treatment with an anti-TNF agent for Felty's syndrome with a review of the literature.
Felty 증후군은 류마티스 관절염에서 비장비대와 백혈구 감소증이 동반된 질환으로 전체 류마티스 관절염의 약 1%에 해당하는 비교적 드문 질환으로 불응성인 경우 항TNF 제제를 사용하여 질병 활성도를 낮출 수 있다. 그러나 장기간 사용 시 동반될 수 있는 악성 종양, 비흑색종 피부암 등의 발생 여부를 유의 깊게 관찰해야겠다. 저자들은 Felty 증후군 환자에서 Adalimumab 치료 중 발견한 보웬병을 진단하여 문헌고찰과 함께 증례 보고하는 바이다.