Goodnough L T, Muir W A
Arch Intern Med. 1980 Nov;140(11):1526-7.
We describe a patient with chronic lymphocytic leukemia (CLL) and bullous pemphigoid. Initial treatment with high-dose prednisone (60 mg/day for 14 days) failed to prevent occurrence of new skin lesions. After the addition of chlorambucil, 6 mg/day, and tapering the prednisone dosage, no new skin lesions appeared, and the bullous lesions rapidly resolved. We were unable to isolate an antibody produced by leukemic lymphocytes that is directed against subepithelial basement membrane. Nevertheless, we believe that bullous pemphigoid can be a peripheral manifestation of an underlying disease such as CLL. Confirmation of this would be aided by the isolation of antibody produced by leukemic cells that is directed against subepithelial basement membrane.
我们描述了一名患有慢性淋巴细胞白血病（CLL）和大疱性类天疱疮的患者。初始使用大剂量泼尼松（60毫克/天，共14天）治疗未能预防新皮肤病变的出现。在加用苯丁酸氮芥（6毫克/天）并逐渐减少泼尼松剂量后，未出现新的皮肤病变，且大疱性病变迅速消退。我们未能分离出白血病淋巴细胞产生的针对上皮下基底膜的抗体。然而，我们认为大疱性类天疱疮可能是诸如CLL等潜在疾病的外周表现。白血病细胞产生的针对上皮下基底膜的抗体的分离将有助于证实这一点。
