病情与外周血嗜酸粒细胞计数平行的大疱性类天疱疮一例

报告1例病情与外周血嗜酸粒细胞计数相平行的大疱性类天疱疮.患者男,65岁.全身泛发红斑、水疱1个月,加重15天.皮肤科检查:皮损泛发头面颈、躯干、四肢及会阴部,基本损害为正常皮肤或红斑基础上出现大小不等的水疱,疱液为草黄色,散在红色糜烂面,尼氏征阴性,部分皮损表面敷以灰褐色痂片,以胸背部、四肢尤为严重.组织病理、直接免疫荧光、间接免疫荧光及盐裂皮肤直接免疫荧光检查结果符合大疱性类天疱疮.入院后依据病情变化,先后给予3次糖皮质激素冲击治疗,治疗过程中,定期监测血常规,提示外周血嗜酸粒细胞计数随病情波动.

Peripheral blood eosinophil count is parallel with the severity of bullous pemphigoid: a case report

To report a case of bullous pemphigoid whose severity is parallel with peripheral blood eosinophil count.A 65-year-old man presented with generalized erythema and blisters for 1 month,which had been aggravated for 15 days.Skin examination revealed irregularly sized blisters with grass-yellow fluid developing on normal skin or erythematous patches in the head,neck,face,trunk,limbs and perineum.Nikolsky's sign was negative.Erythematous erosions were observed and some lesions were covered with greybrown crusts.The chest,back and limbs were predominantly affected by these lesions.Histopathological,direct immunofluorescence (DIF) and indirect immunofluorescence (IIF) examination as well as DIF examination of salt-split skin revealed characteristic changes suggestive of bullous pemphigoid.After admission,he was sequentially given 3 sessions of pulse treatment with high dose glucocorticoids.Routine blood test was performed with regular interval during the treatment,and the results of these tests implied that peripheral blood eosinophil count is parallel to the severity of bullous pemphigoid.