药物诱导性天疱疮 6 例分析。

Analysis of 6 cases of drug-induced pemphigus.

机构信息

Chinese Academy of Medical Sciences, Peking Union Medical College, Nanjing, China.

出版信息

Eur J Dermatol. 2011 Sep-Oct;21(5):696-9. doi: 10.1684/ejd.2011.1428.

DOI:10.1684/ejd.2011.1428

PMID:21697060

Abstract

OBJECTIVES

To study clinical and laboratory characteristics of drug-induced pemphigus.

METHODS

Using direct immunofluorescence (IF), indirect IF, ELISA and immunoblotting to characterize 6 patients with drug-induced pemphigus (DIP) and compared them with 20 cases of idiopathic pemphigus.

RESULTS

All the 6 cases of DIP showed obvious itching (100%) and no damage to the oral mucosa. Five out of 6 DIP cases (83.33%) presented as pemphigus folicaeus (PF) since they contained circulating Dsg1-specific IgG, were sensitive to low doses of glucocorticoid, and had good prognosis. One case was showed as pemphigus vulgaris (PV). Dsg1-specific IgA was positive in peripheral blood of 4 cases (66.67%), and the antibody disappeared after treatment. In patients with idiopathic pemphigus, only 6 cases (30%) had mild itching, and 12 cases (60%) had oral mucosal lesions. Twelve cases (60%) were PV with anti-Dsg1 and -Dsg3 antibodies, and 8 cases (40%) were PF with anti-Dsg1 antibody only. One case (5%) had anti-Dsg1 IgA.

CONCLUSION

Drug factors should be considered for pemphigus as some common antibiotics can cause pemphigus.

摘要

目的

研究药物诱导性天疱疮的临床和实验室特征。

方法

采用直接免疫荧光（IF）、间接 IF、ELISA 和免疫印迹法对 6 例药物诱导性天疱疮（DIP）患者进行特征分析，并与 20 例特发性天疱疮患者进行比较。

结果

6 例 DIP 患者均表现出明显的瘙痒（100%），无口腔黏膜损害。5 例 DIP 患者（83.33%）表现为寻常型天疱疮（PF），因为他们含有循环 Dsg1 特异性 IgG，对小剂量糖皮质激素敏感，且预后良好。1 例表现为落叶型天疱疮（PV）。4 例（66.67%）患者外周血中存在 Dsg1 特异性 IgA，治疗后抗体消失。在特发性天疱疮患者中，仅有 6 例（30%）有轻度瘙痒，12 例（60%）有口腔黏膜损害。12 例（60%）为 PV，抗 Dsg1 和 -Dsg3 抗体阳性，8 例（40%）为 PF，仅抗 Dsg1 抗体阳性。1 例（5%）患者存在抗 Dsg1 IgA。