疱疹样天疱疮  

Herpetiform pemphigus:a case report

作　　者：李文静[1] 高琳[1] 王刚[1] 

机构地区：[1]第四军医大学西京皮肤医院,陕西西安710032

出　　处：《临床皮肤科杂志》2013年第5期287-288,共2页Journal of Clinical Dermatology

摘　　要：报告1例疱疹样天疱疮。患者女,76岁。全身红斑、水疱伴痛痒2个月。既往原发性高血压病史17年,2型糖尿病病史7年。皮肤科检查:全身多发环状红斑,散在水疱、脓疱、糜烂及结痂。皮损组织病理检查:表皮角质层下可见一水疱,棘细胞海绵水肿,有较多嗜酸性粒细胞浸润。真皮浅层有大量嗜酸性粒细胞和淋巴细胞。直接免疫荧光:棘细胞之间IgG网状沉积;间接免疫荧光:表皮细胞间IgG(+);天疱疮自身抗体:desmoglein(Dsg)1(+),Dsg3(-)。诊断:疱疹样天疱疮。给予甲泼尼龙与氨苯砜联用后皮疹消退。A case of hert）etiform pemphigus is reported. The patient was a 76-year-old woman with two-month history of pruritic erythema and vesicles all over the body, 17-year history of hypertension, and 7-year history of type-II diabetes mel- litus. Dermatological examination showed generalized eruption of multiple annular erythema; scattering vesicles, pustules, ero- sions and scabs. Histopathologic examination revealed subcorneal vesicles and intracellular spongiosis in stratum spinosum with profuse eosinophilic infiltration. Eosinophils and lymphocytes were seen in the superficial derails. Direct immunofluorescence showed retiform pattern of intracellular IgG deposits in stratum spinosum; Indirect immunofluorescence demonstrated IgG（＋） be- tween epidermal cells; autoimmune antibodies for pemphigus showed Dsgl（＋） and Dsg3（-）. The patient was diagnosed as her- petiform pemphigus. The lesions resolved after administration of methylprednisolone and dapsone.

关 键 词：疱疹样天疱疮 嗜酸性粒细胞 氨苯砜 

分 类 号：R758.66[医药卫生—皮肤病学与性病学]