Bullous delayed pressure urticaria (DPU) is a rare variant of DPU. Treatment of DPU is difficult and the underlying pathogenic mechanism of DPU remains elusive. We report a 72-year-old man with DPU and associated chro...Bullous delayed pressure urticaria (DPU) is a rare variant of DPU. Treatment of DPU is difficult and the underlying pathogenic mechanism of DPU remains elusive. We report a 72-year-old man with DPU and associated chronic urticaria as well as delayed urticarial dermographism. Pressure challenge gave rise to a deep weal covered by multiple vesicles and bullae after 24 h. Histological examination of a skin biopsy specimen obtained 24 h after pressure challenge demonstrated intraepidermal bullae filled with eosinophils accompanied by a dense, predominantly eosinophilic infiltrate in the dermis. Whereas the numbers and morphology of mast cells were unaltered, the extracellular deposition of eosinophil cationic protein revealed evidence for eosinophil activation. Concomitantly, both CD4+and CD8+T lymphocytes were present in the infiltrate and expressed interleukin 5. As bullous DPU may represent the maximal variant of DPU, the investigation of the cellular infiltrate and the chemokines/cytokines released may reveal potential pathogenic mechanisms. A possible effector role of eosinophilic granulocytes, T-cell subsets and mast cells is discussed.展开更多
患者男,63岁,因头晕、大细胞性贫血于2010年3月21日来我院门诊拟行胃镜检查.术前含服胃镜润滑胶浆,术后3 h自觉喉头发紧,全身瘙痒,出现风团样皮疹,渐出现呼吸困难,急来院住院.查体：呼吸频率30次/min,脉搏98次/min,血压110/70 mm Hg（1 ...患者男,63岁,因头晕、大细胞性贫血于2010年3月21日来我院门诊拟行胃镜检查.术前含服胃镜润滑胶浆,术后3 h自觉喉头发紧,全身瘙痒,出现风团样皮疹,渐出现呼吸困难,急来院住院.查体：呼吸频率30次/min,脉搏98次/min,血压110/70 mm Hg（1 mm Hg=0.133 kPa）,急性病容,呼吸急促,喘息,口唇指端发绀,满肺可闻及大量哮鸣音,未闻及水泡音,心律齐,各瓣膜未闻及杂音,面部、颈部及全身出现大片状扁平皮疹,皮疹颜色与正常皮肤一致,皮肤划痕征阳性,血氧饱和度降至0.75.展开更多
文摘Bullous delayed pressure urticaria (DPU) is a rare variant of DPU. Treatment of DPU is difficult and the underlying pathogenic mechanism of DPU remains elusive. We report a 72-year-old man with DPU and associated chronic urticaria as well as delayed urticarial dermographism. Pressure challenge gave rise to a deep weal covered by multiple vesicles and bullae after 24 h. Histological examination of a skin biopsy specimen obtained 24 h after pressure challenge demonstrated intraepidermal bullae filled with eosinophils accompanied by a dense, predominantly eosinophilic infiltrate in the dermis. Whereas the numbers and morphology of mast cells were unaltered, the extracellular deposition of eosinophil cationic protein revealed evidence for eosinophil activation. Concomitantly, both CD4+and CD8+T lymphocytes were present in the infiltrate and expressed interleukin 5. As bullous DPU may represent the maximal variant of DPU, the investigation of the cellular infiltrate and the chemokines/cytokines released may reveal potential pathogenic mechanisms. A possible effector role of eosinophilic granulocytes, T-cell subsets and mast cells is discussed.
文摘患者男,63岁,因头晕、大细胞性贫血于2010年3月21日来我院门诊拟行胃镜检查.术前含服胃镜润滑胶浆,术后3 h自觉喉头发紧,全身瘙痒,出现风团样皮疹,渐出现呼吸困难,急来院住院.查体：呼吸频率30次/min,脉搏98次/min,血压110/70 mm Hg（1 mm Hg=0.133 kPa）,急性病容,呼吸急促,喘息,口唇指端发绀,满肺可闻及大量哮鸣音,未闻及水泡音,心律齐,各瓣膜未闻及杂音,面部、颈部及全身出现大片状扁平皮疹,皮疹颜色与正常皮肤一致,皮肤划痕征阳性,血氧饱和度降至0.75.
