文献简介

出版社:JAMA Dermatology

作  者:Guannan Zhu, MD, PhD;Wenjun Liao,MD, PhD

编  号:

关键字:大疱性Wells综合征

年  份:2019   点击量:260

文献摘要 全文翻译

A man in his 40s was admitted to the hospital with a 10-day history of edema and presented with vesicles and bullae on his right cheek, neck, back, both eyelids, and the dorsal surface of his hands (Figure 1A). Prior to presentation, he had been treated for herpes zoster with famciclovir for 1 week, during which the lesions kept developing and were accompanied with irregular fever (maximum temperature, 39°C). Physical examination revealed edema on both eyelids; multiple papules, blisters, and crusted erosions with thin exudation on his right cheek and neck; and erythematous plaques and tense blisters and bullae on his back and on the dorsal surface of both hands (Figure 1B). A full laboratory workup was performed for autoantibodies for systemic lupus erythematosus (SLE), pemphigus, and bullous pemphigoid; skin and bone-marrow biopsies and direct immunofluorescence were performed; and immunohistochemichal analysis, a swab of exudation, and bacterial, fungal, and atypicalmycobacterial cultures from blood and tissue were also examined.

患者男性,40余岁,因水肿10天,右面颊、颈部、背部、双眼睑和双手背侧出现水疱和大疱入院就诊(图1A)。发病前,患者曾采用泛昔洛韦治疗带状疱疹1周,在此期间皮损持续发展并伴有不规则发热(最高温度39°C)。体格检查发现两眼睑均水肿;面颊和颈部可见多发丘疹、水疱和糜烂痂皮伴有轻微渗出物;且患者背部和双手背侧有红斑和紧张水疱和大疱(图1B)。对系统性红斑狼疮(SLE)、天疱疮和大疱性天疱疮自身抗体进行了全面实验室检查。进行皮肤和骨髓活检和直接免疫荧光检查;同时进行免疫组织化学分析、渗出拭子以及血液和组织的细菌、真菌和非典型分枝杆菌培养物检查。