寻常性银屑病合并结节性类天疱疮1例并文献复习

Psoriasis vulgaris complicated with pemphigoid nodularis:a case report and literature review

报告1例寻常性银屑病合并结节性类天疱疮。患者男,56岁,既往有银屑病病史8年。全身红斑、风团反复发作1年余,双上肢丘疹伴瘙痒1个月。皮肤科检查:头皮散在红斑,上覆鳞屑;背部及四肢散在红色斑块,边界清楚,上覆银白色鳞屑;躯干及四肢大片红斑、风团;头部、背部及四肢暗褐色丘疹、结节,未见水疱、大疱及脓疱。皮损组织病理检查:角化过度,角化不全,表皮不规则增生,表皮下可见裂隙,真皮浅层血管周围可见淋巴细胞及少量嗜酸性粒细胞浸润。间接免疫荧光:IgG沉积于真表皮交界处。酶联免疫吸附试验(ELISA):抗大疱性类天疱疮抗原1(BP230)抗体和抗大疱性类天疱疮抗原2(BP180)抗体阳性。诊断:寻常性银屑病合并结节性类天疱疮。

A case of psoriasis vulgaris complicated with pemphigoid nodularis is reported.A 56-year-old man with an 8-year history of psoriasis vulgaris was admitted into the hospital for an extensive eruption on his trunk and extremities,with persistent erythema and wheals that had lasted one year and pruritic nodules for one month.Physical examination revealed scaly erythematous plaques on his back and limbs.There were nodules on his head,trunk,and extremities,some with excoriations and all without blisters.Histopathological examination showed hyperkeratosis,parakeratosis,irregular epidermal hyperplasia,cracks under the epidermis,lymphocytes and sporadic eosinophil infiltration around the superficial vessels of the dermis.Indirect immunofluorescence showed IgG deposition at the junction between dermis and epidermis.Serum antibodies to BP230 and BP180 were both positive in serum enzyme-linked immunosorbent assay(ELISA).The diagnosis of psoriasis vulgaris complicated by pemphigoid nodularis was made.