Gruber G G, Owen L G, Callen J P
J Am Acad Dermatol. 1980 Dec;3(6):619-22. doi: 10.1016/s0190-9622(80)80077-6.
The vesicular variant of bullous pemphigoid (BP) is a clinical entity in which the principal types of lesions are multiple small tense vesicles in a symmetric distribution, rather than large, more randomly distributed bullae. We present a patient who developed an intensely pruritic eruption which clinically was suggestive of typical dermatitis herpetiformis (DH), but subsequently developed large bullae typical of BP. Histologic and immunofluorescence findings, as well as initial response to systemic corticosteroids, were typical of BP. In addition, our patient required the administration of methotrexate to maintain clearance of lesions while prednisone was being tapered, a problem which has not been mentioned in the other patients, described in the literature with vesicular variants of BP.
大疱性类天疱疮（BP）的水疱型是一种临床实体，其主要皮损类型为多个对称分布的小紧张性水疱，而非大的、分布更随机的大疱。我们报告一例患者，其出现剧烈瘙痒性皮疹，临床上提示典型的疱疹样皮炎（DH），但随后出现了BP典型的大水疱。组织学和免疫荧光检查结果以及对系统性糖皮质激素的初始反应均为BP的典型表现。此外，我们的患者在逐渐减少泼尼松用量时需要使用甲氨蝶呤来维持皮损消退，这一问题在文献中描述的其他BP水疱型患者中未被提及。
