我们报告了两例白塞病（Behçet's disease, BD）患者出现的下肢溃疡病例，这些病例对常规免疫抑制治疗（CIST）不敏感，但通过添加阿达木单抗（Adalimumab, ADA)成功治疗。BD可以影响任何大小和类型的血管，是一种全身性血管炎。在血管系统中，静脉是最常见的受累血管，而下肢深静脉血栓（DVT）和反复发作的浅表静脉血栓性静脉炎（SVT）则是该病在下肢的最常见血管病征。与血管炎或深静脉血栓症相关的下肢溃疡在BD患者中罕见。CIST对于预防复发和降低后血栓后综合症（PTS）的风险非常关键。对于对这些治疗不敏感的BD相关静脉血栓症患者，可使用肿瘤坏死因子-α（TNF-α）抑制剂单独或与传统疾病修正抗风湿药物（DMARDs）联合使用。鉴于这些信息，我们认为添加ADA治疗对这两位患者是适当的。这种干预对患者来说在第6个月末非常令人满意。然而，需要进一步研究直接评估TNF-α抑制剂单独对BD下肢溃疡的疗效。© 2023年日本风湿病学院，由牛津大学出版社发表。

We report two cases with leg ulcers in Behçet's disease (BD) resistant to conventional immunosuppressive therapy (CIST) alone but successfully treated with adding on adalimumab (ADA). BD, which can affect vessels of any size and type, is a systemic vasculitis. In the vascular system, veins are the most predominatly affected blood vessels with deep vein thrombosis (DVT) and recurrent superficial vein thrombophlebitis (SVT) that are the most common vascular signs of the disease in the lower extremities. Leg ulcers, commonly associated with vasculitis or deep vein thrombosis, are rare in patients with BD. CIST is very critical to prevent relapses and diminish the risk of post-thrombotic syndrome (PTS). In patients with BD-associated venous thrombosis (DVT or SVT) resistant to these treatments, tumor necrosis factor- (TNF)- α inhibitors can be used alone or in combination with traditional disease-modifying antirheumatic drugs (DMARDs). In the view of such information, add-on ADA treatment was considered appropriate for both patients. Response to this intervention was highly satisfying for the patients at the end of the 6th month. Nonetheles, it warrants further studies directly evaluating the efficacy of TNF-α inhibitors alone on leg ulcers in BD.© Japan College of Rheumatology 2023. Published by Oxford University Press.