寻常性银屑病合并自身免疫性大疱性皮肤病13例临床分析  

Clinical analysis of 13 patients with psoriasis vulgaris complicated with autoimmune bullous diseases

作　　者：周健[1] 刘宇 俞晨[1] 王刚[1] ZHOU Jian;LIU Yu;YU Chen;WANG Gang(Department of Dermatology,Xijing Hospital of the Fourth Military Medical University,Xi’an 710032,China)

机构地区：[1]第四军医大学西京医院皮肤科,陕西西安710032

出　　处：《临床皮肤科杂志》2024年第7期387-392,共6页Journal of Clinical Dermatology

基　　金：陕西省重点研发计划项目(2024SF-YBXM-284)资助项目。

摘　　要：目的:分析寻常性银屑病合并自身免疫性大疱性皮肤病患者的临床特点、诊断及治疗。方法:回顾性分析2008—2021年西京医院皮肤科确诊寻常性银屑病合并自身免疫性大疱性皮肤病住院患者的临床资料。结果:收集13例寻常性银屑病合并自身免疫性大疱性皮肤病患者,其中男8例,女5例,平均年龄(44.69±8.02)岁。所有患者于银屑病发生后平均(14.85±7.54)年合并自身免疫性大疱性皮肤病。所有患者中7例合并天疱疮(其中1例伴有汞中毒),5例合并大疱性类天疱疮(1例确诊肺腺癌),1例合并成人型线状Ig A大疱性皮病。7例患者采用糖皮质激素和(或)免疫抑制剂治疗,6例予单用免疫抑制剂治疗。出院后随访2个月~13年,10例患者治愈或病情稳定,3例失访。结论:寻常性银屑病可合并多种自身免疫性大疱性皮肤病,临床较为少见。患者多为银屑病病程中出现水疱、大疱性皮损,明确诊断需结合皮损组织病理表现、免疫荧光、疱病自身抗体等检查结果综合判断。提示临床上需警惕合并汞中毒可能,并重视对肿瘤的筛查和随访,根据疱病严重程度制定合理的治疗方案。Objective:To analyze the clinical features and treatment of the patients with psoriasis vulgaris complicated with autoimmune bullous diseases.Methods:The data of the patients diagnosed as psoriasis vulgaris complicated with autoimmune bullous diseases in Xijing Hospital from 2008 to 2021 was analyzed retrospectively.Results:Thirteen patients with psoriasis vulgaris complicated with autoimmune bullous diseases were collected,including 8 males and 5 females.The average age was 44.69±8.02 years.The mean duration between psoriasis and autoimmune bullous diseases onset was 14.85±7.54 years.There were seven patients diagnosed as pemphigus,five patients diagnosed as bullous pemphigoid and one patient with adult linear IgA bullous disease.Of the seven patients with pemphigus,one was diagnosed with mercury poisoning.One patient with bullous pemphigoid was diagnosed with lung adenocarcinoma during a follow-up visit.Seven patients were treated with systemic corticosteroids and/or immunosuppressive agents while the other six patients were only treated with immunosuppressive agents.After a follow-up of 2 months to 13 years,ten patients recovered or remained stable,while three patients lost to follow-up.Conclusions:It is not common for the patients with psoriasis vulgaris coexisted with autoimmune bullous disease.When the patients with psoriasis present with blisters,a diagnosis of psoriasis vulgaris coexisted with autoimmune bullous disease should be considered and can be made with histopathological examination in combination with immunofluorescence studies to document the presence of autoantibodies.Mercury poisoning and tumor screening may be considered.Reasonable treatment should be initiated promptly based on the severity of the disease.

关 键 词：银屑病 自身免疫性大疱性皮肤病 天疱疮 大疱性类天疱疮 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]