Tijjani B M, Masoodi I, Hassan S N
Department of Medicine Bayero University and Aminu Kano Teaching Hospital, Kano, Nigeria.
Niger J Med. 2013 Oct-Dec;22(4):354-6.
The stratified squamous epithelial lining of the esophagus is similar to that of the skin, and occasionally conditions that affect the skin tend to have esophageal manifestations. Autoimmune dermatological conditions that present with blisters are referred to as bullous dermatoses and have been found to rarely present with esophageal involvement. Esophageal epithelium is thought to be involved in rare occasions because of its identical epithelial lining to the skin and tends to be more frequent among patients with pemphigus vulgaris than in those with pemphigoid. Common symptoms from esophageal involvement in bullous dermatoses may include heartburn, odynophagia or dysphagia. Rarely, it may present with vomiting of sloughed cast of esophageal mucosa or haematemesis. We present S A, a 47 year old female who was on outpatient treatment in 2010 at King Fahad Medical City for bullous pemphigoid but developed progressive odynophagia with massive haematemesis. She was admitted and resuscitated, and endoscopy revealed sloughing of esophageal mucosa and bleeding in keeping with esophagitis dissecans superficialis. Although association of esophageal dissecans superficialis with pemphigus vulgaris has been sparsely reported; to our knowledge its association with bullous pemphigoid as in our case has been rarely reported in English medical literature.
食管的复层鳞状上皮内衬与皮肤相似，偶尔影响皮肤的病症也会出现食管表现。出现水疱的自身免疫性皮肤病被称为大疱性皮肤病，已发现其很少累及食管。食管上皮被认为在极少数情况下会受累，原因是其上皮内衬与皮肤相同，且在寻常型天疱疮患者中比类天疱疮患者更常见。大疱性皮肤病累及食管的常见症状可能包括烧心、吞咽痛或吞咽困难。极少数情况下，可能会出现食管黏膜脱落物呕吐或呕血。我们报告了一位47岁的女性患者S A，她于2010年在法赫德国王医疗城门诊治疗大疱性类天疱疮，但后来出现进行性吞咽痛并伴有大量呕血。她入院后接受了复苏治疗，内镜检查显示食管黏膜脱落和出血，符合浅表性剥脱性食管炎。虽然浅表性剥脱性食管炎与寻常型天疱疮的关联已有少量报道；据我们所知，像我们病例中这种浅表性剥脱性食管炎与大疱性类天疱疮的关联在英文医学文献中很少被报道。
