Tadiotto Cicogna Giulia, Ferranti Martina, Vaccari Daniele, Alaibac Mauro
Unit of Dermatology, University of Padua, Padova, Italy.
BMJ Case Rep. 2019 Jul 19;12(7):e230037. doi: 10.1136/bcr-2019-230037.
A 68-year-old woman was referred to the unit of dermatology for a large basal cell carcinoma on the chin. She was treated with imiquimod cream 5%, and 4 weeks after she developed isolated and grouped tense serum-filled vesicles and bullae on lips, nose, scalp, ankles and lumbar area, and then expanded to the whole body. Histological examination was consistent with a subepidermal bullous dermatosis. Moreover, direct immunofluorescence showed linear deposition of IgA at the basement membrane zone supporting the diagnosis of linear IgA bullous dermatosis (LABD). Dapsone 50 mg/day was administered, and the lesions gradually improved within some weeks, and no new lesions appeared. The temporal relationship between the application of the drug and the development of the disease indicates a role of this topical agent in triggering LABD.
一名68岁女性因下巴处的巨大基底细胞癌被转诊至皮肤科。她接受了5%咪喹莫特乳膏治疗，4周后，她的嘴唇、鼻子、头皮、脚踝和腰部出现了孤立的、成群的紧张性充满血清的水疱和大疱，随后扩展至全身。组织学检查符合表皮下大疱性皮肤病。此外，直接免疫荧光显示IgA在基底膜带呈线性沉积，支持线状IgA大疱性皮肤病（LABD）的诊断。给予每日50毫克氨苯砜治疗，数周内皮损逐渐改善，且未出现新的皮损。药物应用与疾病发生之间的时间关系表明这种外用药物在引发LABD中起作用。
