Su W P, Oursler J R, Muller S A
Department of Dermatology, Mayo Clinic, Rochester, MN 55905.
J Am Acad Dermatol. 1994 May;30(5 Pt 2):841-4. doi: 10.1016/s0190-9622(94)70093-1.
Multiple flaccid bullae, erosions, and tense bullae developed in a 67-year-old man with chronic lymphocytic leukemia. A biopsy specimen revealed features of typical pemphigus vulgaris (suprabasilar clefting with acantholysis), paraneoplastic pemphigus (necrotic keratinocytes and hydropic degeneration in addition to acantholysis), and bullous pemphigoid (subepidermal separation and epidermal regeneration). Direct and indirect immunofluorescence studies revealed deposits of immunoglobulins and C3 within the intercellular substance and basement membrane zone in some specimens. Immunoprecipitation of serum revealed four polypeptides with molecular weights of 250, 230, 210, and 190 kd.
一名67岁的慢性淋巴细胞白血病男性患者出现了多个松弛性水疱、糜烂和紧张性水疱。活检标本显示有典型寻常型天疱疮的特征（基底上裂隙伴棘层松解）、副肿瘤性天疱疮的特征（除棘层松解外还有坏死性角质形成细胞和细胞水肿变性）以及大疱性类天疱疮的特征（表皮下分离和表皮再生）。直接和间接免疫荧光研究在一些标本中显示细胞间物质和基底膜带内有免疫球蛋白和C3沉积。血清免疫沉淀显示有分子量为250、230、210和190kd的四种多肽。
