鼻部局限性天疱疮一例

A case of localized pemphigus in nose

56岁男性患者,鼻部红斑、糜烂、结痂2个月余。皮肤科情况:鼻部红斑,边界清,红斑基础上部分糜烂,部分呈污秽色、黑褐色油腻性厚痂,尼氏征(±)。抗棘细胞桥粒抗体阳性。组织病理表现为棘层松解伴皮内水疱形成,直接免疫荧光检查示:免疫球蛋白G(IgG)(网格状+)。诊断:寻常型天疱疮。给予甲泼尼龙24mg每日1次口服,治疗2周后皮损基本消退。

A 56-year-old male patient presented with nasal erythema, erosion and crust for more than 2 months. The patient had been once misdiagnosed as zygomycosis. Dermatology examination showed nasal erythema with clear border, partial erosion on the basis of erythema, and some area with filthy color and covered by dark brown greasy crust, Nikolsky sign(±). Epidermal intercellular desmosome antibodies were positive. The histopathological features were acantholysis with intradermal blisters forming. Direct immunofluorescence was positive for IgG(reticular +). Diagnosis: pemphigus vulgaris. Methylprednisolone tablet was given 24 mg orally once a day, after 2 weeks of treatment, the lesions basically disappeared.