老年类天疱疮

Pemphigoid in the Elderly

大疱性类天疱疮(bullous pemphigoid,BP)是老年人群当中最常见的自身免疫性水疱病,它的主要特点是血清中存在抗基底膜带抗体,与基底膜带相应抗原结合,通过炎症细胞的激活破坏基底膜带,从而引起病理或肉眼可见的水疱,可累及皮肤和粘膜。BP180是BP的最重要的抗原。随年龄增长,BP发病率逐渐提高。老年人发生BP后,有较高的死亡率。BP临床表现主要是紧张性的瘙痒性水疱,部分患者临床表现不典型,可不出现明显水疱。BP的诊断依赖于临床表现、病理表现、免疫病理表现和血清学检查。BP在治疗上,目前首选的治疗是局部或者系统用糖皮质激素,部分患者对非激素治疗也可能有效。

Bullous pemphigoid (BP) is the most common autoimmune vesicular disease in the elderly. Its main feature is the presence of anti-basement membrane antibody in serum, which binds to the corresponding antigen of the basement membrane and destroys the basement membrane through activation of inflammatory cells. The band, which causes pathological or macroscopic blisters, can affect the skin and mucous membranes. BP 180 is the most important antigen of BP. With the increase of age,the incidence of BP gradually increases. Older people have a higher mortality rate after BP. The clinical manifestations of BP are mainly irritative blistering blister, and some patients have atypical clinical manifestations without obvious blisters. The diagnosis of BP depends on clinical manifestations,pathological findings,immunopathological findings,and serological tests. In the treatment of BP, the current preferred treatment is local or systemic glucocorticoids, and some patients may also be effective by non-hormone therapy.