Takemiya M, Shiraishi S, Miki Y
Department of Dermatology, University of Ehime School of Medicine, Japan.
Dermatologica. 1990;180(2):102-5. doi: 10.1159/000248003.
A 77-year-old man was seen with florid, vegetating nodules in the umbilical, axillary and inguinal areas, scaly erythema in the trunk and fragile nails. Histologically, marked to moderate acanthosis and papillomatosis with intraepidermal abscesses composed of acantholytic cells, eosinophils and neutrophils were seen in the vegetating lesions which showed intercellular IgG deposit by the direct immunofluorescence technique. There were no circulating pemphigus antibodies. The lesions were successfully treated by topical corticosteroids. However, flaccid bullae with hypopyon showing subcorneal acantholysis and intercellular IgG deposits continued to develop. After 3 1/2 years, circulating pemphigus antibody of IgG2 subclass was demonstrated.
一名77岁男性患者，脐部、腋窝及腹股沟区出现大量增生性结节，躯干有鳞屑性红斑，指甲脆弱。组织学检查显示，增生性病变中有显著至中度棘层肥厚和乳头瘤样增生，伴有由棘层松解细胞、嗜酸性粒细胞和中性粒细胞组成的表皮内脓肿，直接免疫荧光技术显示细胞间IgG沉积。无循环性天疱疮抗体。局部使用皮质类固醇成功治疗了这些病变。然而，出现了伴有前房积脓的松弛性大疱，表现为角质层下棘层松解和细胞间IgG沉积，并持续发展。3年半后，检测到IgG2亚类的循环性天疱疮抗体。
