San Diego Family Dermatology, National City, CA 91950, USA.
College of Osteopathic Medicine, Touro University California, Vallejo, CA 94589, USA.
Medicina (Kaunas). 2021 Apr 20;57(4):398. doi: 10.3390/medicina57040398.
Dyshidrosiform bullous pemphigoid is a variant of bullous pemphigoid. At least 84 patients with dyshidrosiform bullous pemphigoid have been described. Dyshidrosiform bullous pemphigoid usually presents with pruritic blisters in elderly individuals; the hemorrhagic or purpuric lesions on the palms and soles can be the only manifestation of the disease. However, bullae may concurrently or subsequently appear on other areas of the patient's body. Patients typically improve after the diagnosis is established and treatment is initiated. The mainstay of therapy is systemic corticosteroids, with or without topical corticosteroids, and systemic dapsone or immunosuppressants. Drug-related or nickel-induced dyshidrosiform bullous pemphigoid improves after stopping the associated agent; however, systemic therapy has also been required to achieve resolution of the blisters. Similar to classic bullous pemphigoid, neurologic conditions and psychiatric disorders have been observed in dyshidrosiform bullous pemphigoid patients. The new onset of recurrent or persistent blisters on the palms, soles, or both of an elderly individual should prompt the clinician to consider the diagnosis of dyshidrosiform bullous pemphigoid.
汗疱疹样大疱性类天疱疮是大疱性类天疱疮的一种变体。至少已经描述了 84 例汗疱疹样大疱性类天疱疮患者。汗疱疹样大疱性类天疱疮通常发生于老年人，表现为瘙痒性水疱；手掌和足底的出血性或紫癜性损害可能是该病的唯一表现。然而，水疱可能同时或随后出现在患者身体的其他部位。在确诊并开始治疗后，患者通常会有所改善。治疗的主要方法是全身性皮质类固醇，联合或不联合局部皮质类固醇，以及全身性氨苯砜或免疫抑制剂。与药物或镍相关的汗疱疹样大疱性类天疱疮在停用相关药物后会改善；然而，也需要全身治疗才能使水疱消退。与经典大疱性类天疱疮类似，汗疱疹样大疱性类天疱疮患者也观察到神经状况和精神障碍。老年人手掌、足底或两者同时出现新发复发性或持续性水疱时，临床医生应考虑汗疱疹样大疱性类天疱疮的诊断。
