银屑病并发大疱性类天疱疮  

Psoriasis complicated with bullous pemphigus

作　　者：曹杜玲 匡叶红[1] 刘盼盼[1] 朱武[1] CAO Du-ling;KUANG Ye-hong;LIU Pan-pan;ZHU Wu(Department of Dermatology,Xiangya Hospital,Central South University,Changsha China,410000)

机构地区：[1]中南大学湘雅医院皮肤科,湖南长沙410000

出　　处：《临床皮肤科杂志》2022年第4期226-229,共4页Journal of Clinical Dermatology

摘　　要：例1.男,32岁。全身鳞屑性红斑17年,臀部及腰部水疱2个月。皮肤科检查:躯干及四肢可见散在红斑,表面少许鳞屑,腰腹部可见成簇紧张性水疱,疱液清亮,尼氏征阴性,无口腔及会阴糜烂。取水疱行组织病理检查,结果示表皮下水疱,直接免疫荧光示IgG、Ig M和C3沿基膜呈线状沉积。诊断:寻常性银屑病;大疱性类天疱疮。予克拉霉素口服及哈西奈德乳膏外用病情好转。例2.男,72岁。全身鳞屑性红色斑块32年,散在水疱7 d。皮肤科检查:躯干及四肢多发鳞屑性红色斑块,上臂及腹部正常皮肤及红色斑块边缘散在水疱,水疱松弛,部分水疱表面破裂形成糜烂,无口腔及会阴糜烂,无疼痛,尼氏征阴性。取水疱行病理检查,示表皮下水疱,直接免疫荧光C3沿基膜呈线状沉积,IgG、IgM及IgA(-)。诊断:寻常性银屑病;大疱性类天疱疮。予地塞米松10 mg,静脉滴注,每日1次,卤米松三氯生乳膏外用,病情好转。Case 1:A 32-year-old male patient was admitted to the hospital due to scaly erythematous plaques all over the body and blisters on the buttocks and waist for 2 months.Dermatological examination showed erythema with a little scale on the surface scattered on the trunk and limbs,clusters of tense blisters on the waist and abdomen with clear blister fluid,negative Nissl’s sign,no oral and perineal erosions.Histopathological biopsy of the blisters suggested subepidermal blisters.Direct immunofluorescence indicated linear deposition of IgG,IgM and C3 along the basement membrane.Diagnosis:1.Bullous pemphigoid.2.Psoriasis vulgaris.The patient’s condition was improved after treatment with oral clarithromycin and topical hacinide cream.Case 2:A 72-year-old male patient was admitted to hospital with scaly erythematous plaques all over the body for 32 years,and scattered blisters for 7 days.Dermatological examination showed multiple scaly erythematous plaques on the trunk and extremities,scattered blisters on the forearm and abdomen,and some ruptured blisters formed erosions,no oral and perineal erosions and Nissl’s sign was negative.Histopathological biopsy of the blisters revealed subepidermal blisters.Direct immunofluorescence showed linear deposition of C3 basement membrane with IgG,IgM,and IgA(-).Diagnosis 1.Bullous pemphigoid.2.Psoriasis vulgaris.Her condition was improved after intravenous administration of dexamethasone and topical halogenated triclosan cream.

关 键 词：银屑病 大疱性类天疱疮 

分 类 号：R758.63[医药卫生—皮肤病学与性病学] R758.66[医药卫生—临床医学]