Truss Adam, Papalexandris Stylianos, Gardner Susan, Harvey Robert
Department of Surgery, Arrowe Park Hospital, Wirral, UK.
BMJ Case Rep. 2019 Apr 5;12(4):e227440. doi: 10.1136/bcr-2018-227440.
An elderly Caucasian woman developed bullous pemphigoid (BP) overlying the site of total knee arthroplasty for osteoarthritis 2 days after surgery. The clinical findings were consistent with blistering due to soft tissue swelling, bullous impetigo or allergic contact dermatitis. The blistering spread over weeks to months down the ipsilateral leg and then to the other leg and hips. A biopsy for H&E and direct immunofluorescence established the diagnosis of BP. A concomitantly occurring wound infection was identified and treated. The blistering responded well to superpotent topical steroids and local care.
一名老年白种女性在全膝关节置换术治疗骨关节炎术后2天，手术部位出现大疱性类天疱疮（BP）。临床症状与软组织肿胀、大疱性脓疱疮或过敏性接触性皮炎引起的水疱相符。水疱在数周数月内蔓延至同侧下肢，随后又蔓延至另一侧下肢及臀部。通过苏木精-伊红染色（H&E）及直接免疫荧光检查进行活检，确诊为BP。同时发现并治疗了伤口感染。水疱对超强效外用类固醇及局部护理反应良好。
