Caltabiano Rosario, Magro Gaetano, Puzzo Lidia, Vasquez Enrico, De Pasquale Rocco
Section of Anatomic Pathology, Department G.F. Ingrassia, University of Catania, 95123 Catania, Italy.
Case Rep Med. 2011;2011:518758. doi: 10.1155/2011/518758. Epub 2011 Mar 16.
We describe the case of a 67-year-old woman affected by pemphigus vulgaris with a dry whitish scaly lesion in the upper lip. Clinically, this lesion resembled an actinic keratosis. Although histological examination revealed a focal acantholysis, the finding of a moderate-to-severe dysplastic epithelium was consistent with the diagnosis of acantholytic actinic keratosis with moderate/severe dysplasia. Nevertheless, the complete resolution of the lip lesion after systemic therapy for pemphigus vulgaris led us to reconsider the possibility that we were dealing with a pemphigus vulgaris with unusual clinical and histological features. The previously reported cytological dysplasia was better regarded reactive rather than neoplastic, likely as the result to the inflammatory injury.
我们描述了一名67岁患有寻常型天疱疮的女性病例，其在上唇有一个干燥的白色鳞屑性病变。临床上，该病变类似于光化性角化病。尽管组织学检查显示有局灶性棘层松解，但中度至重度发育异常上皮的发现与中度/重度发育异常的棘层松解性光化性角化病的诊断一致。然而，寻常型天疱疮全身治疗后唇部病变完全消退，这使我们重新考虑我们面对的可能是具有不寻常临床和组织学特征的寻常型天疱疮。先前报道的细胞学发育异常更可能被视为反应性而非肿瘤性，可能是炎症损伤的结果。
