Department of Dermatology, Hangzhou Third People's Hospital, Hangzhou City, People's Republic of China.
Cutis. 2022 May;109(5):E19-E21. doi: 10.12788/cutis.0526.
Pemphigus vulgaris (PV) is a rare life-threatening condition of the pemphigus group of autoimmune blistering diseases. Systemic glucocorticoids are the cornerstone of management for PV, but complications can arise from their long-term use. We report a case of recurrence of a well-controlled case of PV that could not be alleviated by a combination of steroids, mycophenolate mofetil, and high-dose intravenous immune proteins. The patient had developed numerous complications during previous glucocorticoid therapy, including hypertension, diabetes, glaucoma, cataracts, optic nerve atrophy, aseptic necrosis of the femoral head, osteoporosis, and pulmonary tuberculosis. We determined that recurrence of PV and treatment resistance were consequences of the interaction between the antitubercular agent rifampicin that the patient was taking and corticosteroids. Pemphigus vulgaris was quickly controlled after the rifampicin was discontinued.
寻常型天疱疮（PV）是天疱疮自身免疫性大疱病组中一种罕见的危及生命的疾病。全身性糖皮质激素是 PV 治疗的基石，但长期使用会产生并发症。我们报告了一例经类固醇、霉酚酸酯和大剂量静脉免疫球蛋白联合治疗后，病情得到良好控制的寻常型天疱疮复发的病例。该患者在之前的糖皮质激素治疗中已出现多种并发症，包括高血压、糖尿病、青光眼、白内障、视神经萎缩、股骨头无菌性坏死、骨质疏松症和肺结核。我们确定天疱疮复发和治疗抵抗是患者正在服用的抗结核药物利福平与皮质类固醇相互作用的结果。停用利福平后，寻常型天疱疮迅速得到控制。
