红皮病性大疱性类天疱疮合并白癜风1例

Erythrodermic Bullous Pemphigoid coexist with Vitiligo:A Case Report

患者男,67岁,因全身红斑、鳞屑伴瘙痒3年,双下肢水疱3个月就诊。有白癜风和2型糖尿病等病史数十年。皮肤科情况:颜面部、躯干及四肢弥漫性红斑,上覆鳞屑,其间散在分布大小不等、边界清楚的色素脱失斑,部分呈融合趋势。双下肢红斑基础上数个大小不等的张力性水疱,无黏膜损伤,尼氏征阴性。水疱组织病理示表皮下水疱;皮损周围皮肤直接免疫荧光检查示C3沿基底膜带呈线状沉积;血清抗BP180抗体检测阳性。诊断:红皮病性大疱性类天疱疮,白癜风。系统应用糖皮质激素治疗后红斑及水疱逐渐消退,白癜风皮损无明显改善。

A 67-year-old male presented with diffuse erythema,scaling,and pruritus over the entire body for 3 years and blisters on lower extremities for 3 months.He has a history of vitiligo and type 2 diabetes for several decades.Dermatological examination:diffuse erythematous plaques on the face,trunk,and extremities,covered with scales,scattered in the distribution of different sizes of well-defined pigment-deficient patches,some of the trend of fusion.Several large and tensive blisters of different sizes were found based on erythema of the lower extremities.No mucosal damage was found and Nikolsky′s sign was negative.Pathological examination of the blisters suggested subepidermal blisters.Direct immunofluorescence of the skin around the lesions suggested linear deposits of C3 in the basement membrane zone.Serum anti-BP180 antibodies were quantified positively.Diagnosis:erythrodermic bullous pemphigoid.The erythema and blisters subsided after treatment with systemic glucocorticoids,but the rash of vitiligo didn′t improve significantly.