无水疱性类天疱疮二例并文献复习
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摘要
报道2例无水疱性类天疱疮并复习以往相关文献。例1,男,72岁,因全身皮肤红斑、丘疹伴瘙痒20天就诊,查体未见水疱。实验室检查血嗜酸性粒细胞升高,直接免疫荧光示基底膜带线状C3沉积,间接免疫荧光示抗基底膜带抗体阳性,抗BP230抗体、抗BP180抗体阳性。例2,女,79岁。因全身皮肤散在分布丘疹伴严重瘙痒20天就诊,查体见躯干四肢皮肤抓痕明显,未见水疱。血清中抗BP180抗体阳性。2例均诊断:无水疱性类天疱疮。予以小剂量糖皮质激素治疗后,控制病情,目前在随访中。
Two cases with nonbullous pemphigoid is reported and relative literature is reviewed. One 72-years-old male presented with erythema and papules accompanied by pruritus all over the body for 20 days. On physical examination, there were no visible blisters. The level of eosinophils in blood was increased. Direct immunofluorescence showed a positive linear C3 deposition along the basal membrane band and indirect immunofluorescence showed anti-BP230 antibody and anti-BP180 antibody were positive. Another 79-year-old female presented with papules all over the body with serve pruritus for 20 days. Physical examination showed obvious scratches without blisters. Eosinophil and anti-BP180 antibody were increased. Both cases were diagnosed as nonbullous pemphigoid. The disease was well controlled after using small dose glucocorticoid.
Two cases with nonbullous pemphigoid is reported and relative literature is reviewed. One 72-years-old male presented with erythema and papules accompanied by pruritus all over the body for 20 days. On physical examination, there were no visible blisters. The level of eosinophils in blood was increased. Direct immunofluorescence showed a positive linear C3 deposition along the basal membrane band and indirect immunofluorescence showed anti-BP230 antibody and anti-BP180 antibody were positive. Another 79-year-old female presented with papules all over the body with serve pruritus for 20 days. Physical examination showed obvious scratches without blisters. Eosinophil and anti-BP180 antibody were increased. Both cases were diagnosed as nonbullous pemphigoid. The disease was well controlled after using small dose glucocorticoid.
引文
[1] Schmidt E,Zillikens D.Pemphigoid diseases[J].Lancet,2013,381(9863):320-332.
[2] Asbrink E,Hovmark A.Clinical variations in bullous pemphigoid with respect to early symptoms[J].Acta Derm Venereol,1981,61(5):417-421.
[3] Bakker CV,Terra JB,Pas HH,et al.Bullous pemphigoid as pruritus in the elderly:a common presentation[J].JAMA Dermatol,2013,149(8):950-953.
[4] Lamberts A,Meijer JM,Jonkman MF.Nonbullous pemphigoid:A systematic review[J].J Am Acad Dermatol,2018,78(5):989-995.
[5] Schmidt E,Zillikens D.The diagnosis and treatment of autoimmune blistering skin diseases[J].Deutsch Arztebl Int,2011,108(23):399-405.
[6] Barker DJ.Generalized pruritus as the presenting feature of bullous pemphigoid[J].Br J Dermatol,1983,109(2):237-239.
[7] Sardy M,Kostaki D,Varga R,et al.Comparative study of direct and indirect immunofluorescence and of bullous pemphigoid 180 and 230 enzyme-linked immunosorbent assays for diagnosis of bullous pemphigoid[J].J Am Acad Dermatol,2013,69(5):748-753.
[8] Arbache ST,Nogueira TG,Delgado L,et al.Immunofluorescence testing in the diagnosis of autoimmune blistering diseases:overview of 10-year experience[J].An Bras De Dermatol,2014,89(6):885-889.
[9] Zhang Y,Luo Y,Han Y,et al.Non-bullous lesions as the first manifestation of bullous pemphigoid:A retrospective analysis of 181 cases[J].J Dermatol,2017,44(7):742-746.
[10] Sun C,Chang B,Gu H.Non-bullous lesions as the first manifestation of bullous pemphigoid:a retrospective analysis of 24 cases[J].J Dermatolog Treat,2009,20(4):233-237.
[2] Asbrink E,Hovmark A.Clinical variations in bullous pemphigoid with respect to early symptoms[J].Acta Derm Venereol,1981,61(5):417-421.
[3] Bakker CV,Terra JB,Pas HH,et al.Bullous pemphigoid as pruritus in the elderly:a common presentation[J].JAMA Dermatol,2013,149(8):950-953.
[4] Lamberts A,Meijer JM,Jonkman MF.Nonbullous pemphigoid:A systematic review[J].J Am Acad Dermatol,2018,78(5):989-995.
[5] Schmidt E,Zillikens D.The diagnosis and treatment of autoimmune blistering skin diseases[J].Deutsch Arztebl Int,2011,108(23):399-405.
[6] Barker DJ.Generalized pruritus as the presenting feature of bullous pemphigoid[J].Br J Dermatol,1983,109(2):237-239.
[7] Sardy M,Kostaki D,Varga R,et al.Comparative study of direct and indirect immunofluorescence and of bullous pemphigoid 180 and 230 enzyme-linked immunosorbent assays for diagnosis of bullous pemphigoid[J].J Am Acad Dermatol,2013,69(5):748-753.
[8] Arbache ST,Nogueira TG,Delgado L,et al.Immunofluorescence testing in the diagnosis of autoimmune blistering diseases:overview of 10-year experience[J].An Bras De Dermatol,2014,89(6):885-889.
[9] Zhang Y,Luo Y,Han Y,et al.Non-bullous lesions as the first manifestation of bullous pemphigoid:A retrospective analysis of 181 cases[J].J Dermatol,2017,44(7):742-746.
[10] Sun C,Chang B,Gu H.Non-bullous lesions as the first manifestation of bullous pemphigoid:a retrospective analysis of 24 cases[J].J Dermatolog Treat,2009,20(4):233-237.