红斑型天疱疮误诊为寻常性银屑病1例  

Pemphigus Erythematosus Misdiagnosed1 as Psoriasis Vulgaris:Case Report

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作  者:杨颜龙 张禁 王文岭 于水 张美楠 周亚光 冯歆越 赵梓纲 李恒进 YANG Yanlong;ZHANG Jin;WANG Wenling;YU Shui;ZHANG Meinan;ZHOU Yaguang;FENG Xinyue;ZHAO Zigang;LI Hengjin(Department of Dermatology,the Hainan Hospital of Chinese People's Liberation Army General Hospital,Sanya 572013,China;Wuhan Special Service Recuperation Center,Wuhan 430000,China)

机构地区:[1]中国人民解放军总医院海南医院皮肤科,海南三亚572013 [2]武汉特勤疗养中心,湖北武汉430000

出  处:《皮肤科学通报》2023年第5期616-619,共4页Dermatology Bulletin

摘  要:患者男性,35岁,全身起红色斑块、鳞屑反复发作2年余,再发半月余,曾在多家医院诊断为“银屑病”、“过敏性皮炎”、“湿疹”、“红斑狼疮”及“天疱疮?”,效果欠佳。实验室检查:血常规无异常、ANA(-)、ENA抗体谱均为(-);组织病理显示:表皮内水疱位于颗粒下层,疱内可见稀疏棘层松解细胞,伴中性粒细胞和淋巴细胞浸润,散在坏死角质形成细胞,基地膜带尚完整,真皮浅层周围血管及间质性淋巴细胞,浸润散在色素颗粒及嗜色素细胞;直接免疫荧光:IgG(++)、C3(+)呈网状沉积于棘细胞间。诊断:红斑型天疱疮。治疗:环孢素软胶囊口服0.15,3次/d,糖皮质激素软膏外用2次/d,疗效明显。A 35-year-old male patient presented with red plaques and scaly recurring all over his body for more than 2 years,and recurrence for more than half a month.His disease had been diagnosed with"psoriasis","allergic dermatitis",“eczema”,"lupuserythematosus"and"pemphigoid?"in many hospitals,but the effect is not good.Laboratory examination:Blood routine is normal,ANA(-),ENA antibody profile are all(-).Histopathological examination revealed intraepidermal blisters are located under the granular layer,Sparse acantholytic cells can be seen in the blisters,with infiltration of neutrophils and lymphocytes,scattered in necrotic keratinocytes,base membranes are still intact,blood vessels and interstitial lymphocytes around the superficial dermis,Infiltrate scattered pigment granules and chromaffin cells.Immunological examination showed that IgG(++)and C3(+)are deposited in the thorn cells in a network.The diagnosis of erythematous pemphigus was made.The patient was treated with cyclosporine soft capsule,0.15g,3/d.Glucocorticoid ointment applied externally,the effect is obvious.

关 键 词:红斑型天疱疮 误诊 银屑病 

分 类 号:R751[医药卫生—皮肤病学与性病学]

 

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