银屑病合并大疱性类天疱疮继发卡波西肉瘤一例

2018-02-01 佚名 中华皮肤科杂志

患者40余年前患有银屑病,2年前出现红斑水疱,确诊为大疱性类天疱疮。

【现病史】

患者40余年前患有银屑病,2年前出现红斑水疱,确诊为大疱性类天疱疮。

【治疗】

系统使用大剂量糖皮质激素和免疫抑制剂后,双下肢出现增生性肿物,通过病理、免疫组化等方法确诊为免疫抑制相关型卡波西肉瘤。及时给予激素减量、X线照射及局部手术治疗后肿物消失。

【讨论】

银屑病合并大疱性类天疱疮,其具体发病机制尚不完全清楚,可能与光疗、局部外用糖皮质激素等有关。再次出现卡波西肉瘤则与使用免疫抑制剂后,使得免疫监视作用障碍或受损,提高了对HHV-8的易感性,导致该病毒大量激活和感染,促进局部血管的生成和炎症的发生,诱发卡波西肉瘤的发生。因此,对在银屑病、大疱性类天疱疮等疾病应避免过度治疗,系统免疫抑制治疗的副作用不容忽视,提醒广大同行警惕免疫抑制型卡波西肉瘤的发生。HHV-8的检测对确诊卡波西肉瘤具有较高的特异性和敏感性。




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    2019-01-14 feifers
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    2018-02-02 大爰

    学习了谢谢分享!!

    0

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    2018-02-01 131****1460

    学习了受益匪浅

    0

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