在寻常型天疱疮采用泼尼松单药治疗时出现的播散性蜂窝织炎型隐球菌病。

Disseminated cellulitic cryptococcosis in the setting of prednisone monotherapy for pemphigus vulgaris.

作者信息

Yoo Simon S, Tran Mark, Anhalt Grant, Barrett Terry, Vonderheid Eric C

机构信息

Department of Dermatology, Johns Hopkins Medical Institutes, Baltimore, Maryland 21287, USA.

出版信息

J Dermatol. 2003 May;30(5):405-10. doi: 10.1111/j.1346-8138.2003.tb00407.x.

DOI:10.1111/j.1346-8138.2003.tb00407.x

PMID:12773807

Abstract

Cryptococcal infections are seen mainly in immunocompromised hosts. The cutaneous manifestations of infection can include papules, plaques, nodules, vesicles, ulcers, ecchymosis, and, rarely, cellulitis. Cryptococcal meningitis is a life-threatening complication of this disease. Pemphigus vulgaris is a rare auto-immune blistering disease that can also be life-threatening. Treatment of pemphigus commonly entails both corticosteroids and steroid-sparing agents. We present a case of disseminated cryptococcal infection in a patient with pemphigus vulgaris treated with high dose corticosteroids as monotherapy. This case provides an opportunity to discuss the difficulty of managing two potentially mortal conditions in which the treatment of pemphigus vulgaris may exacerbate the disseminated cryptococcal infection.

摘要

隐球菌感染主要见于免疫功能低下的宿主。感染的皮肤表现可包括丘疹、斑块、结节、水疱、溃疡、瘀斑，很少见蜂窝织炎。隐球菌性脑膜炎是该疾病的一种危及生命的并发症。寻常型天疱疮是一种罕见的自身免疫性水疱病，也可能危及生命。寻常型天疱疮的治疗通常需要使用皮质类固醇和免疫抑制剂。我们报告一例接受高剂量皮质类固醇单药治疗的寻常型天疱疮患者发生播散性隐球菌感染的病例。该病例为讨论同时管理两种潜在致命疾病的困难提供了机会，其中寻常型天疱疮的治疗可能会加重播散性隐球菌感染。