文献简介

出版社:JAMA Dermatology

作  者:Oluwatobi A. Ogbechie, BA; A. Brooke Eastham, MD; Ruth Ann Vleugels, MD, MPH

编  号:

关键字:Dyshidrosiform pemphigoid

年  份:2015   点击量:172

文献摘要 全文翻译

A man in his 70s presented with a 2-week history of a bullous eruption localized to the hands and feet. He denied having pruritus or spontaneous bleeding but reported discomfort from the pressure of intact bullae. His medical history was notable for diabetes mellitus and hypertension, which was well controlled with a stable regimen of lisinopril and atenolol for several years. He denied using any new medications or supplements or making recent dose adjustments in existing medications. There was no history of a prior bullous eruption. Physical examination revealed numerous small intact bullae and large erosions on the lateral feet, soles, and toes (Figure, A). The extent of the bullae led to difficulty with ambulation. There were also intact vesicles on the lateral palms along with erosions demonstrating evidence of previous bullae formation. There were no vesicular or bullous lesions on the trunk, arms, legs, or mucosal surfaces. Hematoxylin-eosin staining of a biopsy specimen obtained from a bulla on the foot was performed (Figure, B).

患者男性,70余岁,两周前手部和脚底出现大疱疹。患者否认有瘙痒感或自发出血,但自述因完整大疱的压力而感到不适。患者有显著糖尿病和高血压史,几年来坚持采用赖诺普利和阿替洛尔治疗得以很好控制。患者未采用过任何新药或补充剂,也未对现有药物的剂量进行调整。且患者无大疱疹病史。体格检查发现足外侧、足底和脚趾可见大量小的完整大疱和大面积糜烂(图A)。广泛大疱导致行走困难。手掌外侧也可见完整的大疱,且有糜烂证实曾有大疱存在。躯干、手臂、腿或粘膜表面未出现水疱或大疱皮损。从足部大疱处取活检标本进行HE染色(图B)。