以非水疱为初发皮疹的大疱性类天疱疮34例

Clinical analysis of 34 cases of bullous pemphigoid with non-bullous lesions as initial manifestation

目的探讨以非水疱为初发皮疹的大疱性类天疱疮患者的临床表现、实验室检查和治疗特点。方法回顾性分析34例以非水疱为初发皮疹的大疱性类天疱疮患者的临床资料。结果34例患者中男女之比1．83：1，始发年龄平均为（59．79±15．63）岁。在出现典型的水疱之前，表现为红斑、丘疹、丘疱疹、斑块、风团、结节、多形红斑样皮疹等多形性表现，以同时出现红斑、丘疹，斑块（占35．29％）为多见。结论在所分析的病例中，近1／3大疱性类天疱疮患者初发表现为多形性，以同时出现红斑、丘疹，斑块多见。

Objective To analyse the clinical and therapeutic features as well as laboratory findings in bullous pemphigoid with non-bullous lesions as initial manifestation. Methods Clinical data on 34 cases of bullous pemphigoid with non-bullous lesions as initial manifestation were retrospectively analyzed. Results The male to female ratio was 1.83 ： 1, with a mean age of onset at 59.79 ± 15.63 years. Before typical bullae appeared, patients presented with erythema, papules, papulovesicles, plaques, wheals, nodules, or erythema multiforme-like lesions, with the most common lesions being erythematous papules and plaques （occurring in 35.29% of these patients）. Conclusions Among these patients, nearly 1/3 displayed various skin lesions at the onset; simultaneous erythematous papules and plaques are the most common initial manifestation.