Wanke N C, Bruce M C, De Aguilar E J, Pinto F M
Med Cutan Ibero Lat Am. 1984;12(3):209-13.
A 39 years old black woman with systemic lupus erythematosus developed tense bullae on erythematous bases on the flexor surfaces of the forearms and oral cavity. Some blisters healed with atrophy and pruritus was a striking feature. The diagnosis of systemic lupus erythematosus was based upon the following criteria: the typical blush in the butterfly area, alopecia, a painful macular papular eruption on the palms and fingers, fever, arthralgia, anemia, leukopenia, elevation of erythrocyte sedimentation rate and positive ANA. Histologic examination showed a subepidermal bulla formation and perivascular inflammatory infiltrate containing lymphocytes and eosinophils. By indirect immunofluorescence no autoantibodies were detected. Direct immunofluorescence showed deposition of linear IgG. High doses of prednisone brought about clinical remission but there was no response to sulfone. The patient is on maintenance dose. The authors discuss the differences between the three diseases and conclude that the bullous eruption cannot be classified.
一名39岁的患有系统性红斑狼疮的黑人女性，在前臂屈侧和口腔出现了以红斑为基底的紧张性大疱。一些水疱愈合后出现萎缩，瘙痒是一个显著特征。系统性红斑狼疮的诊断基于以下标准：蝶形区域典型的红斑、脱发、手掌和手指上疼痛性斑丘疹、发热、关节痛、贫血、白细胞减少、红细胞沉降率升高以及抗核抗体阳性。组织学检查显示表皮下水疱形成，血管周围有淋巴细胞和嗜酸性粒细胞浸润的炎症浸润。间接免疫荧光检查未检测到自身抗体。直接免疫荧光显示线性IgG沉积。高剂量泼尼松使临床症状缓解，但对砜类药物无反应。患者接受维持剂量治疗。作者讨论了这三种疾病之间的差异，并得出大疱性皮疹无法分类的结论。
