Jordaan H F, Heyns C F, Allen F J, Schneider J
Department of Dermatology, Tygerberg Hospital, South Africa.
Clin Exp Dermatol. 1990 Nov;15(6):442-5. doi: 10.1111/j.1365-2230.1990.tb02140.x.
Pemphigus vulgaris is an uncommon auto-immune disease which responds well to treatment with corticosteroids and azathioprine. Malakoplakia is a rare granulomatous disease associated with coliform infections and an altered cellular immune response. We report a 68-year-old female patient with pemphigus vulgaris who, after 2 years on maintenance prednisone and azathioprine immunotherapy, developed malakoplakia of the bladder associated with chronic E. coli urinary-tract infection. The malakoplakia responded well to treatment with cotrimoxazole, bethanechol chloride and ascorbic acid, combined with tapering of the corticosteroid dosage. Our patient presents an uncommon but interesting complication of long-term immunosuppressive therapy for pemphigus vulgaris.
寻常型天疱疮是一种罕见的自身免疫性疾病，对皮质类固醇和硫唑嘌呤治疗反应良好。软斑病是一种罕见的肉芽肿性疾病，与大肠埃希菌感染及细胞免疫反应改变有关。我们报告一名68岁患寻常型天疱疮的女性患者，在接受泼尼松和硫唑嘌呤维持免疫治疗2年后，出现与慢性大肠埃希菌尿路感染相关的膀胱软斑病。软斑病经复方新诺明、氯化贝胆碱和维生素C治疗，同时逐渐减少皮质类固醇剂量后，病情好转。我们的患者出现了寻常型天疱疮长期免疫抑制治疗一种罕见但有趣的并发症。
