PD-1抑制剂诱发大疱性类天疱疮一例

Bullous pemphigoid induced by multiple tumors was treated with PD-1 inhibitor:a case report

患者,女,54岁。周身红斑、水疱伴痒20天。既往“右侧结肠癌”术后并发全身多部位转移14年,近2年内间断使用帕博丽珠单抗治疗,皮肤科检查:全身散在分布绿豆至蚕豆大水疱,部分融合成大疱。组织病理示:表皮轻度角化,基底层下水疱形成,水疱内较多嗜酸粒细胞、中性粒细胞、单一核细胞浸润。免疫荧光:基底膜带IgG、C3呈线状沉积。诊断:大疱性类天疱疮。

A 54-year-old female presented with erythema,vesicles and itching for 20 days.It has been 14 years since the operation of“right colon cancer”complicated with multiple systemic metastases.In the past 2 years,intermittent treatment of Pablizumab was used.Dermatology showed mung bean to broad bean blisters scattered throughout the body,some fused to huge blisters.Pathology showed that the epidermis slightly keratinized,and the blister formed under the basal layer and there were more eosinophils,neutrophils and mononuclear cells in the blister.Immunofluorescence showed that IgG and C3 were linearly deposited in the basement membrane.The diagnosis of bullous pemphigoid was made.