扁平苔藓样BP200类天疱疮

Lichen planoid BP200 pemphigoid

报告1例扁平苔藓样BP200类天疱疮。全身反复发作红斑、水疱伴剧烈瘙痒8个月。皮肤科检查:口腔黏膜局部糜烂,全身散在分布大小不等红斑及圆形和不规则形暗红色色素沉着斑片,以躯干部及双上肢为著,皮损基底部为紫红色斑片和斑块,部分斑片表面结痂。皮损组织病理:表皮轻度角化,基底细胞液化变性、色素失禁,真皮浅层嗜酸性粒细胞浸润,淋巴细胞呈带状分布。皮损周围正常组织行直接免疫荧光:基膜带处IgG及C3呈线状沉积。诊断:扁平苔藓样BP200类天疱疮。治疗:甲泼尼龙40 mg,静脉滴注,阿维A 20 mg,口服,经10 d治疗后皮损明显好转。

A case of Lichen planus BP200 pemphigoid was reported.The patient experienced recurrent erythema,blisters,and intense pruritus throughout the body for 8 months.the lesions were scattered throughout the body,mainly in the trunk and the upper limbs.The base of the lesions was purplish red spots and plaques.Thick scabs were visible on some spots,and local erosion of the oral mucosa was visible.Scattered round and irregular dark red pigmentation patches of varying sizes were observed throughout the body,and no obvious abnormalities were observed in the remaining skin mucous membranes.Histopathological examination showed mild keratosis in the epidermis,liquefy degeneration of basal cells and incontinence of pigment.Eosinophils were visible in the superficial dermis,and lymphocytes were distributed in bands.Immunofluorescence:IgGt,C3++deposited in the basal membrane band in a linear manner.The patient was diagnosed with lichen planus BP200 pemphigoid and received intravenous infusion of methylprednisolone 40 mg,along with oral administration of Acitretin 20 mg.After 10 days of treatment,the lesions were significantly better than before.