The patient,a 33-year-old male,was admitted to hospital due to recurrent erythematous patches on the skin,oral and genital mucosal erosions for over 3 years,and developed localized blisters on both hands within the past 5 days.The dermatological examination revealed circular erythematous patches around the right eye orbit,perioral area,right elbow,and lower leg on the right side.Superficial erosions were observed on the oral and genital mucosa,along with scattered tense blisters on the fingertips.The laboratory examination revealed heightened levels of BP 180 antibodies associated with pemphigoid.The histopathological examination of the erythematous lesions of the lower leg demonstrated necrotic keratinocytes in the epidermis and a predominantly lymphocytic inflammatory infiltrate in the superficial dermis.The histopathological examination of the blistered areas of the right index finger revealed subepidermal blisters characterized by inflammatory infiltrates mainly composed of eosinophils and lymphocytes.The direct immunofluorescence of perilesional skin showed a linear deposition of IgG and complement C3 between the epidermis and dermis.The patient was diagnosed as fixed drug eruption with drug-induced pemphigus.The treatment regimen involved administration of oral prednisone at 30 mg/day for one week,tapered to 15 mg/day for 3 days,followed by 10 mg/day for 4 days before discontinuation.The patient received symptomatic local therapy was advised against use of bezoar detoxification pills for life.The patient's condition was rapidly controlled,and there was no recurrence during the one-year follow-up.
关键词
药疹/固定性药疹/牛黄解毒片/类天疱疮,大疱性
Key words
Drug eruption/Bezoar detoxification pills/Fixed drug eruption/Pemphigus,bullous
维普
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