Lee Ruby, Lobo Yolanka, Spelman Lynda
Veracity Clinical Research, Brisbane, Queensland, Australia.
Gabba Dermatology, Brisbane, Queensland, Australia.
Case Rep Dermatol. 2021 Feb 24;13(1):141-147. doi: 10.1159/000512870. eCollection 2021 Jan-Apr.
Chronic plaque psoriasis is often associated with autoimmune bullous diseases. Dermatitis herpetiformis (DH) is a rare immunobullous disease that has been linked to celiac disease (CD). To our knowledge, the coexistence of psoriasis and DH is uncommon, and has only been described in anecdotal reports. We report a case of chronic plaque psoriasis complicated by DH in a 60-year-old patient with no known history of CD or associated symptoms. In our patient, DH presented atypically as multiple vesicles along the edges of psoriatic plaques located on the back and hips, and as vesiculobullous eruptions on the fingers. The patient was successfully treated with a combination of dapsone and a gluten-free diet for DH, and secukinumab for psoriasis. This case highlights the importance of screening for CD in patients with psoriasis, as well as other concomitant autoimmune diseases. A gluten-free diet should be trialled in psoriatic patients with positive CD serology.
慢性斑块状银屑病常与自身免疫性大疱性疾病相关。疱疹样皮炎（DH）是一种罕见的免疫性大疱性疾病，与乳糜泻（CD）有关。据我们所知，银屑病和DH并存并不常见，仅在个案报道中有所描述。我们报告一例60岁患者，患有慢性斑块状银屑病并伴有DH，既往无CD病史或相关症状。在我们的患者中，DH表现不典型，为背部和臀部银屑病斑块边缘的多个水疱，以及手指上的水疱大疱性皮疹。患者通过使用氨苯砜和无麸质饮食治疗DH，使用司库奇尤单抗治疗银屑病，获得了成功。该病例强调了对银屑病患者以及其他合并的自身免疫性疾病进行CD筛查的重要性。银屑病患者CD血清学检查呈阳性时，应尝试无麸质饮食。
