Saraceno R, Citarella L, Spallone G, Chimenti S
Department of Dermatology, University of Rome Tor Vergata, Rome, Italy.
Clin Exp Dermatol. 2008 Mar;33(2):154-5. doi: 10.1111/j.1365-2230.2007.02603.x. Epub 2007 Nov 16.
Several cases of psoriasis associated with bullous disorders have been reported, and it is clearly recognized that bullous pemphigoid (BP) is the most common bullous disorder observed in association with psoriasis, especially after ultraviolet (UV)B and psoralen UVA therapy. Moreover, other medications have been repeatedly reported to induce bullous diseases, especially pemphigus vulgaris. We report for the first time a case of BP possibly induced by losartan, an angiotensin II antagonist, in a patient with a severe psoriatic background. Angiotensin II type 1 receptor antagonists belong to a new class of drug for hypertension or congestive heart failure with established efficacy and few side-effects. Coexistence of psoriasis vulgaris with bullous diseases represents also a difficult therapeutic challenge. This rare case of psoriasis and generalized BP triggered by a sartan drug was treated with rituximab and etanercept.
已有数例银屑病合并大疱性疾病的病例报道，并且明确认识到大疱性类天疱疮（BP）是与银屑病相关的最常见大疱性疾病，尤其是在紫外线（UV）B和补骨脂素紫外线A疗法之后。此外，其他药物也多次被报道可诱发大疱性疾病，尤其是寻常型天疱疮。我们首次报告了1例可能由血管紧张素II拮抗剂氯沙坦诱发BP的病例，该患者有严重的银屑病背景。1型血管紧张素II受体拮抗剂属于一类用于治疗高血压或充血性心力衰竭的新型药物，疗效确切且副作用少。寻常型银屑病与大疱性疾病并存也代表着一个艰难的治疗挑战。这例罕见的由沙坦类药物引发的银屑病和泛发性BP病例采用利妥昔单抗和依那西普进行了治疗。
