摘要
报告1例脐部天疱疮.患者女,37岁,因口腔血疱、脐周水疱伴瘙痒反复半年就诊.皮肤科检查:脐部可见环形不规则糜烂面,边界清楚,上覆白色分泌物,不伴异味,口腔粘膜未见明显水疱、糜烂.PDAI活动性评分2分.脐部皮损组织病理检查:表皮内庖,疱位于基层上,见棘突松解细胞;真皮浅层较多淋巴细胞.直接免疫荧光:棘细胞间可见IgG、C3网格状沉积,IgM、IgA(-).诊断:寻常型天疱疮.治疗:予甲氨蝶呤注射液10 mg肌注1次,口服甲泼尼龙片24 mg每日1次,辅以补钙,外用卤米松/三氯生乳膏、夫西地酸钠软膏,治疗6 d后糜烂面干涸,好转后出院.6个月后电话随访患者无新发皮损.
Abstract
A case of umbilical pemphigus vulgaris is reported.A 37-year-old female presented with a half-year history of repeated oral blood blisters and periumbilical itchy blisters.Dermatolog-ical examination revealed a demarcated annular irregular erosive surface covered with odorless white secretions on the umbilical area.But neither blisters nor erosions were observed in the oral mucosa.PDAI activity scores were 2 points.Pathological examination of skin lesion showed blis-ters in the basal layer and acantholytic cells in the epidermis,and lymphocytic infiltrations in the superficial dermis.Direct immunofluorescence revealed reticular deposition of IgG and C3 in the intercellular space of the spinous layer,without IgM and IgA depostion.The diagnosis was pem-phigus vulgaris.Patient was treated with intramuscular injection of Methotrexate(10 mg)once,and oral methylprednisolone tablets at a dose of 24 mg once daily,in addition to calcium supple-mentation and topical applications of Halometasone and Sodium Fusidate Ointment.After the skin lesion was improved,the patient was discharged.No new lesions occurred during 6-month phone follow-up.
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