奥马珠单抗治疗大疱性类天疱疮1例

Treatment of Bullous Pemphigoid with Omalizumab:A Case Report

患者男,93岁,全身反复起水疱伴瘙痒3+年,加重1+月。患者长期使用激素控制病情,此次因停药后病情复发加重,皮肤科情况:颈项、躯干及四肢散见蚕豆至鹌鹑蛋大小水疱、血疱,疱壁紧张,尼氏征阴性。躯干及四肢见黄豆至鸡蛋大小糜烂、溃疡面,基底潮红,部分触痛明显。经皮损病理回示确诊为大疱性类天疱疮。排除绝对禁忌症后予奥马珠单抗300 mg皮下注射2次后瘙痒明显缓解,皮损消退。出院后继续每月予奥马珠单抗300 mg皮下注射1次。随访2个月,患者皮损未复发。

A 93-year-old male presented with recurrent generalized blisters with pruritus for 3+years,aggravated for 1+months.The patient had been using hormones for a long time to control the disease,and the recurrence was aggravated after drug withdrawal.Dermatological conditions:scattered fava bean to quail egg sized blisters and hemorrhagic blisters with tense walls were seen on the neck,trunk and extremities,with a negative Nikolsky's sign.The torso and extremities were found to have soybean to egg-sized vesicles and ulcerated surfaces with flushed bases and significant tenderness in some parts.It was diagnosed as bullous pemphigoid by pathological examination.After ruling out absolute contraindications,omalizumab 300 mg was administered subcutaneously for two times and the pruritus was significantly relieved and the lesions subsided.After discharge from the hospital,omalizumab 300 mg was administered on time by monthly subcutaneous injection.The patient's lesions didn't recrudesce at the 2-month follow-up.