PDF(Pubmed)
Abstract：
BACKGROUND: Psoriasis is an immune-related disease caused by genetic factors, abnormalities in the immune system and environmental factors, while pemphigus is an autoimmune disease caused by the autoimmune system attacking the skin and mucosal tissues. Herein, we aimed to report a rare case of adalimumab induced exacerbation of psoriasis patients with pemphigus. The rare disease causes considerable challenges for clinical diagnosis and treatment.
METHODS: The patient was a 43-year-old man with intermittent erythema and scaling all over the body for more than 20 years, and blisters and vesicles on the trunk and limbs for 1 month. Half a year ago, the patient had blisters on the limbs, and was diagnosed with deciduous pemphigus in a hospital, and the blisters subsided after being given traditional Chinese medicine orally. Half a month ago, the erythema area was enlarged, and adalimumab 80 mg intramuscular injection was given for 1 time after consultation in the hospital. On the following day, the area of erythema and scales was suddenly enlarged obviously compared with the previous 1, and obvious blisters and vesicles appeared on the limbs, neck, and trunk, which were aggravated progressively and accompanied by obvious itching and pain.
METHODS: The patient was diagnosed with psoriasis in patients with combined pemphigus.
METHODS: After combined treatment with methylprednisolone and cyclosporine, the skin lesions have basically recovered.
RESULTS: The skin lesions have basically healed. Follow up for 6 months without recurrence.
CONCLUSIONS: Methylprednisolone combined with cyclosporine may be an option in treating patients with psoriasis patients with pemphigus.
METHODS: The patient was a 43-year-old man with intermittent erythema and scaling all over the body for more than 20 years, and blisters and vesicles on the trunk and limbs for 1 month. Half a year ago, the patient had blisters on the limbs, and was diagnosed with deciduous pemphigus in a hospital, and the blisters subsided after being given traditional Chinese medicine orally. Half a month ago, the erythema area was enlarged, and adalimumab 80 mg intramuscular injection was given for 1 time after consultation in the hospital. On the following day, the area of erythema and scales was suddenly enlarged obviously compared with the previous 1, and obvious blisters and vesicles appeared on the limbs, neck, and trunk, which were aggravated progressively and accompanied by obvious itching and pain.
METHODS: The patient was diagnosed with psoriasis in patients with combined pemphigus.
METHODS: After combined treatment with methylprednisolone and cyclosporine, the skin lesions have basically recovered.
RESULTS: The skin lesions have basically healed. Follow up for 6 months without recurrence.
CONCLUSIONS: Methylprednisolone combined with cyclosporine may be an option in treating patients with psoriasis patients with pemphigus.
摘要：
背景：银屑病是一种由遗传因素引起的免疫相关疾病，免疫系统和环境因素的异常，天疱疮是由自身免疫系统攻击皮肤和粘膜组织引起的自身免疫性疾病。在这里，我们的目的是报告一例罕见的阿达木单抗导致银屑病合并天疱疮患者加重的病例.这种罕见疾病给临床诊断和治疗带来了相当大的挑战。
方法：患者是一名43岁的男性，有20多年的间歇性红斑和全身鳞屑，躯干和四肢上的水泡和水泡持续1个月。半年前,病人四肢有水泡,在医院被诊断为乳性天疱疮,口服中药后水泡消退。半个月前,红斑区域扩大了,在医院咨询后给予阿达木单抗80mg肌肉注射1次。第二天,红斑和鳞屑面积较前1例突然明显增大,四肢出现明显水泡和囊泡,脖子,和树干，逐渐加重，并伴有明显的瘙痒和疼痛。
方法：合并天疱疮的患者诊断为银屑病。
方法：甲泼尼龙和环孢素联合治疗后，皮损基本恢复。
结果：皮损基本愈合。随访6个月无复发。
结论：甲基强的松龙联合环孢素可能是治疗银屑病合并天疱疮的一种选择。
方法：患者是一名43岁的男性，有20多年的间歇性红斑和全身鳞屑，躯干和四肢上的水泡和水泡持续1个月。半年前,病人四肢有水泡,在医院被诊断为乳性天疱疮,口服中药后水泡消退。半个月前,红斑区域扩大了,在医院咨询后给予阿达木单抗80mg肌肉注射1次。第二天,红斑和鳞屑面积较前1例突然明显增大,四肢出现明显水泡和囊泡,脖子,和树干，逐渐加重，并伴有明显的瘙痒和疼痛。
方法：合并天疱疮的患者诊断为银屑病。
方法：甲泼尼龙和环孢素联合治疗后，皮损基本恢复。
结果：皮损基本愈合。随访6个月无复发。
结论：甲基强的松龙联合环孢素可能是治疗银屑病合并天疱疮的一种选择。
