Department of Dermatology, Flinders Medical Centre, Adelaide, South Australia, Australia.
Australas J Dermatol. 2011 May;52(2):e11-4. doi: 10.1111/j.1440-0960.2010.00646.x. Epub 2010 Apr 27.
A 76-year-old woman presented with a pruritic photodistributed rash and dysphagia. Serum anti-nuclear antibody was positive (titre 1/1280) and skin and muscle biopsies confirmed a diagnosis of dermatomyositis. She was treated with oral prednisolone (5-50 mg/day), mometasone furoate 0.1% ointment and lotion, and tacrolimus 0.03% ointment. Four years later she presented with multiple painful scaly erosions on the face, scalp and trunk. Histopathology and direct and indirect immunofluorescence confirmed a diagnosis of pemphigus vulgaris. Repeated malignancy screens were negative. She was treated with methotrexate (10 mg/week) and prednisolone (50 mg/day slowly tapered to 5 mg/day), with good control of both diseases.
一位 76 岁女性因瘙痒性、光分布的皮疹和吞咽困难就诊。血清抗核抗体阳性（滴度 1/1280），皮肤和肌肉活检证实为皮肌炎。她接受了口服泼尼松龙（5-50mg/天）、糠酸莫米松 0.1%软膏和洗剂以及他克莫司 0.03%软膏治疗。四年后，她出现面部、头皮和躯干多处疼痛性鳞屑性糜烂。组织病理学和直接及间接免疫荧光证实为寻常型天疱疮。反复进行的恶性肿瘤筛查均为阴性。她接受了甲氨蝶呤（10mg/周）和泼尼松龙（50mg/天，逐渐缓慢减量至 5mg/天）治疗，两种疾病均得到良好控制。
