疱疹样天疱疮1例  

A case of herpetiform pemphigus

作　　者：刘雅芹 陈留鑫 谢映霞 祝瑶 邓诗音 蔡艳霞 LIU Yaqin;CHEN Liuxin;XIE Yingxia;ZHU Yao;DENG Shiyin;CAI Yanxia(Affiliated Hospital of Guangdong Medical University,Zhanjiang 524000,China)

机构地区：[1]广东医科大学附属医院,广东湛江524000

出　　处：《皮肤性病诊疗学杂志》2024年第6期427-431,共5页Journal of Diagnosis and Therapy on Dermato-venereology

基　　金：广东医科大学附属医院临床研究(LCYJ2019C008)。

摘　　要：报告疱疹样天疱疮1例。患者男,76岁。因躯干、四肢红斑、水疱伴瘙痒10个月就诊。皮肤科检查:躯干、四肢见大量红斑、丘疹、色素沉着斑,红斑基础上有针尖至绿豆大小水疱。疱壁较厚,呈半球状,疱液清亮,孤立分布,不融合,尼氏征阴性,部分水疱破溃,见浅糜烂面。皮损组织病理示:表皮内水疱形成,疱内见嗜酸性粒细胞及中性粒细胞,真皮浅层可见血管周淋巴组织细胞、嗜酸性粒细胞浸润。直接免疫荧光:表皮内细胞间IgG、C3网状沉积。诊断:疱疹样天疱疮。入院予甲强龙、环磷酰胺、卢帕他定、酮替芬、外用复方丙素氯倍他索软膏等治疗,9 d后原有水疱大部分干涸,好转后出院。6个月后电话随访患者无复发。A case of herpetiform pemphigus is reported.A 76-year-old man suffered from erythema,blisters and pruritus on the trunk and extremities for 10 months.Dermatological examination revealed a large number of erythemas,papules,hyperpigmented spots and isolated pinpoint-to-green bean-sized blisters over the erythemas on the trunk and limbs.The blisters appeared hemispheric,with thick walls and clear fluid.Nikolsky′s sign was negative.Some blisters were ruptured,with erosive surface.Skin histopathology showed epidermal blisters containing eosinophils and neutrophils,and perivascular infiltrates of lymphohistiocytes and eosinophils in the superficial dermis.Direct immunofluorescence showed reticular deposition of IgG and C3 in the epidermis.Diagnosis was herpetiform pemphigus.The patient was treated with methylprednisolone,cyclophosphamide,rupatadine,ketotifen,and topical compound clobetasol propionate ointment.Nine days later,most of the blisters dried up,and the patient was discharged,without recurrence during 6-month telephone follow-up.

关 键 词：疱疹样天疱疮 糖皮质激素 

分 类 号：R758.66[医药卫生—皮肤病学与性病学]