获得性大疱性表皮松解症伴宫颈鳞状细胞癌一例

患者女,54岁,因反复眼干涩2年,躯干四肢水疱伴口腔破溃2个月入院.皮肤科检查:鼻腔黏膜破溃结痂、充血.口腔大片浅溃疡,可见有水疱,表层水肿发白,边缘充血,下唇散在小溃疡,双峡颊黏膜水肿,溃疡与舌背相似.肩部、颈部及躯干见红斑周围或红斑上散在少许水疱,疱壁稍紧张,疱壁薄,尼氏征可疑阳性.该例以黏膜为突出表现,临床表现类似于瘢痕性类天疱疮,容易误诊,且皮疹和黏膜损害随着肿瘤的病情而转变.获得性大疱性表皮松解症与Ⅶ胶原有关,可能与恶性肿瘤及鳞状细胞癌有一定的相关性.

A case of epidermolysis bullosa acquisita accompanied by cervical squamous cell carcinoma

A 54-year-old woman was hospitalized for a 2-year history of recurrent xerophthalmia and 2 -month history of blisters on the trunk and limbs as well as oral ulcer. Physical examination revealed ulceration and hyperemia of nasal mucosa with crusts, large and shallow ulcer in oral cavity covered with edematous and white surface layer and surrounded by congestive margin, small scattered ulcers on the lower lip, edematous buccal mucosa with ulcers which were similar to the lesions on the dorsum of tongue. There were small number of tense blisters with thin wall scattered around or over the erythema in shoulders, neck, and trunk; Nikolsky sign was absent. This case was characterized by mucosal lesions, which were similar to the manifestation of ci catricial pemphigoid; further, cutaneous and mucosal eruptions in this case varied with the progression of con current tumors. Hence, it was liable to be misdiagnosed. Epidermolysis bullosa acquisita is correlated with type VII collagen. In some situations, the disorder may be linked to maligant tumors such as squamous cell carcino ma.