Rangel Javier
Dermatologist in the Department of Dermatology at the Roseville Medical Center in CA.
Perm J. 2016 Winter;20(1):e101-2. doi: 10.7812/TPP/15-059.
The development of pemphigus, including pemphigus vulgaris (PV) and pemphigus foliaceus, during pregnancy is rare. PV manifests with mucosal and/or cutaneous erosions with flaccid bullae that are histologically characterized by suprabasilar acantholysis. In contrast, pemphigus foliaceus manifests with cutaneous-only involvement and superficial epidermal acantholysis. Enzyme-linked immunosorbent assay specific for autoantibodies against desmoglein 1 and desmoglein 3 aids in the diagnosis and differentiation between pemphigus subtypes. High-dose systemic corticosteroids are first-line agents in management of PV, yet their potential long-term use raises complex management issues associated with pregnancy and fetal risk. Here we report a rare case of cutaneous-limited PV in association with pregnancy.
天疱疮(包括寻常型天疱疮和落叶型天疱疮)在孕期的发生较为罕见。寻常型天疱疮表现为黏膜和/或皮肤糜烂,伴有松弛性水疱,组织学特征为基底上棘层松解。相比之下,落叶型天疱疮仅累及皮肤,表现为表皮浅层棘层松解。针对桥粒芯糖蛋白1和桥粒芯糖蛋白3的自身抗体的酶联免疫吸附测定有助于天疱疮各亚型的诊断和鉴别。高剂量全身性糖皮质激素是寻常型天疱疮治疗的一线药物,但其长期使用可能引发与妊娠和胎儿风险相关的复杂管理问题。在此,我们报告一例与妊娠相关的皮肤局限性寻常型天疱疮罕见病例。