首页|注射司库奇尤单抗后发生大疱性类天疱疮1例

注射司库奇尤单抗后发生大疱性类天疱疮1例

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患者女,71岁,因"全身鳞屑性红斑30年,水疱4个月"于我院就诊.患者30年前全身出现散在鳞屑性红斑,外院诊断为"银屑病",传统药物治疗效果不佳,4个月前外院给予司库奇尤单抗注射治疗,第2次注射后第2天躯干、四肢皮肤出现大量红斑、水疱、大疱.组织病理:表皮下疱形成,疱内可见嗜中性粒细胞;水疱周围表皮角化过度,灶状角化不全,少许核尘,颗粒层变薄,棘层增厚;真皮浅层血管周围少许淋巴细胞、噬色素细胞浸润.直接免疫荧光(DIF):表皮基底膜C3阳性线状沉积;间接免疫荧光(IIF):循环抗体IgG表皮侧阳性沉积.诊断:大疱性类天疱疮、寻常型银屑病.治疗:甲泼尼龙60 mg/d联合甲氨蝶呤15 mg,1周1次,效果良好.1个月后,将甲泼尼龙减量至24 mg/d,大疱性类天疱疮无复发,躯干四肢红斑鳞屑消退.
Bullous Pemphigoid in a Psoriasis Patient After Secukinumab Treatment:A Case Report
A 71-year-old female presented with scaly erythema all over the body for 30 years and blisters for 4 months.Scattered scaly erythema appeared on the whole body 30 years ago,and the patient was diagnosed as"psoriasis"in a another hospital,and the effect of traditional drug treatment was not good.Four months ago,the patient was given secukinumab injection treatment in a another hospital,and a large number of erythematous plaques,blisters,and maculopapular blisters appeared on the skin of the torso and the four limbs on the second day after the second injection.Histopathology:subepidermal blisters were formed,and neutrophils were seen in the blisters;the epidermis around the blisters was hyperkeratotic,focally hyperkeratotic,with a little nuclear dust,thinning of the granular layer,and thickening of the stratum spinosum;there was a little infiltration of lymphocytes and phagocytic pigment cells around the blood vessels in the superficial layer of the dermis;Direct Immunofluorescence(DIF)showed:C3-positive lineal deposition of the epidermal basement membrane.Indirect immunofluorescence(IIF):positive deposition of circulating antibody IgG on the epidermal side.Diagnosis:bullous pemphigoid,psoriasis vulgaris.Treatment:methylprednisolone 60mg/d combined with methotrexate 15 mg once per week.One month later,methylprednisolone was reduced to 24 mg/d,herpetic pemphigoid did not recur,and erythematous scales on trunk and limbs subsided.

SecukinumabBullous pemphigoidBiologics

崔寅玲、杨青、吴卫志、刘永霞、孙勇虎

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山东第一医科大学附属皮肤病医院,山东省皮肤病性病防治研究所,山东济南 250022

司库奇尤单抗 大疱性类天疱疮 生物制剂

国家自然科学基金面上项目

82073441

2024

皮肤科学通报
西安交通大学

皮肤科学通报

CSTPCD
影响因子:0.273
ISSN:1001-8077
年,卷(期):2024.41(2)
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