Stoica Loredana Elena, Patrascu V, Dascalu Rucsandra Cristina, Ciurea M E
Department of Dermatology, University of Medicine and Pharmacy of Craiova.
Department of Dermatology, Emergency County Clinic Hospital of Craiova.
Curr Health Sci J. 2014 Jan;40(1):62-6. doi: 10.12865/CHSJ.40.01.12. Epub 2013 Dec 29.
Bullous pemphigoid (BP) and psoriasis vulgaris represent two clinically well characterized, inflammatory, chronic skin diseases. A 62 years old female patient, from rural areas, was admitted for the presence of erythematous plaques covered by large tense blisters with clear fluid, located symmetrically on the anterior part of the upper limbs, the trunk, the neck and the lower limbs. Also the lesions were intense itching. Lesions occurred three days before presentation at the clinic. Medical history revealed psoriasis diagnosed 28 years ago, breast cancer treated with surgery, radio and chemotherapy three years ago and Parkinson's disease diagnosed 3 weeks prior to presentation to the dermatology clinic. Histopathology examination revealed: atrophic epidermis with subepidermal presence of a blister containing numerous eosinophils and neutrophils. In the papillary dermis neutrophils and eosinophils predominantly vascular. Bullous pemphigoid has multiple etiology. Bullous pemphigoid is an autoimmune subepidermal bullous dermatosis which may be associated with psoriasis. Medical literature and cases reported in dermatology journals claim that bullous pemphigoid is often associated with psoriasis, though the immunogenetical and immunopathologycal mecanismes are still not known. Our patient has three different diseases but their etiology and pathogenesis can interfere.
大疱性类天疱疮(BP)和寻常型银屑病是两种临床特征明显的炎症性慢性皮肤病。一名来自农村地区的62岁女性患者因上肢前部、躯干、颈部和下肢对称出现覆盖有清亮液体的大张力水疱的红斑性斑块而入院。此外,皮损伴有剧烈瘙痒。皮损在就诊前三天出现。病史显示28年前诊断为银屑病,三年前接受了乳腺癌手术、放疗和化疗,在皮肤科就诊前三周诊断为帕金森病。组织病理学检查显示:表皮萎缩,表皮下有一个含有大量嗜酸性粒细胞和中性粒细胞的水疱。在乳头真皮中,中性粒细胞和嗜酸性粒细胞主要位于血管周围。大疱性类天疱疮有多种病因。大疱性类天疱疮是一种自身免疫性表皮下水疱性皮肤病,可能与银屑病有关。医学文献和皮肤科杂志报道的病例称,大疱性类天疱疮常与银屑病相关,但其免疫遗传学和免疫病理学机制仍不清楚。我们的患者患有三种不同的疾病,但其病因和发病机制可能相互影响。