Wang Yiman, Mao Xuming, Liu Yangchun, Li Li
Department of Dermatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China.
Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USA.
Ann Transl Med. 2020 Mar;8(5):249. doi: 10.21037/atm.2020.01.104.
Bullous pemphigoid (BP) is a senile autoimmune blistering disease with autoantibodies against the basement membrane. Less than 20 cases of localized BP in young adults have been reported and the understanding of localized BP is very limited. An unusual location of localized BP is here described. A 30-year-old woman presented with a 4-month history of itchy erythema on her trunk. The lesion, well-demarcated erythema and maculopapules in bra's shape, had been misdiagnosed as contact dermatitis. Laboratory finding was notable for serum autoantibodies to BP antigen 180 (BP180). Histopathological examination revealed a subepidermal blister with eosinophils and neutrophils infiltration. Salt-split indirect immunofluorescence revealed linear deposition of IgG at the dermoepidermal junction. After treating her with minocycline 200 mg and nicotinamide 1,500 mg per day, all lesions resolved within 1 month. Localized BP is usually misdiagnosed. It starts from various triggers and has a more benign disease course. It should be emphasized that a long-term follow-up of patients with localized BP may be important for management of the chronic disease, given a relatively high risk of developing generalized BP.
大疱性类天疱疮（BP）是一种针对基底膜产生自身抗体的老年性自身免疫性水疱病。据报道，在年轻成年人中局限性BP病例不到20例，对局限性BP的了解非常有限。本文描述了一例局限性BP的不寻常发病部位。一名30岁女性，躯干出现瘙痒性红斑4个月。病变为界限清楚的红斑及胸罩形状的斑丘疹，曾被误诊为接触性皮炎。实验室检查显示血清中存在针对BP抗原180（BP180）的自身抗体。组织病理学检查显示表皮下水疱，伴有嗜酸性粒细胞和中性粒细胞浸润。盐裂间接免疫荧光显示IgG在真皮表皮交界处呈线性沉积。每天给予她200mg米诺环素和1500mg烟酰胺治疗后，所有皮损在1个月内消退。局限性BP通常会被误诊。它由多种诱因引发，病程相对良性。应该强调的是，鉴于局限性BP患者发展为泛发性BP的风险相对较高，对其进行长期随访对于这种慢性病的管理可能很重要。
