A case of Hallopeau type of pemphigus vegetans accompanied with ulcerative colitis.
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概要
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A 30-year-0ld man was admitted to our hospital for painful yellowish white pseudomembranes and erosions in the oral mucosa. After hospitalization, numerous malodorous pustules appeared on his whole scalp. Later, these pustules were growing into several round vegetated lesions.<BR>Cultures and microscopic examinations of the pustular materials obtained from the oral mucosa and scalp were always negative for various kinds of bacteria and fungi.<BR>Antifungal and antibacterial therapies did not result in a favorable response.<BR>Biopsy specimens obtained from the lesions of the oral mucosa and scalp showed marked acanthosis papillomatosis, suprabasal acantholysis and intraepidermal abscesses composed of numerous eosinophils and neutrophils. Direct and indirect immunofluorescence examinations showed the presence of pemphigus-antibody in the epidermal intercellular spaces. Therefore, the diagnosis of Hallopeau type of pemphigus vegetans was made. The patient was treated with prednisolone tablets 40 mg daily, and thereafter his condition improved rapidly.<BR>It is emphasized that the immunofluorescence studies were necessary for a differential diagnosis between Hallopeau type of pemphigus vegetans and pyoderma vegetans.<BR>In our case, it is interesting that the patient had ulcerative colitis which is related to various skin diseases, particularly erythema nodosum, pyoderma gangrenosum and pyoderma vegetans including pyostomatitis vegetans.<BR>It is suggested that Hallopeau type of pemphigus vegetans may be nummbered among the skin diseases accompanied with ulcerative colitis.
- 日本皮膚科学会大阪地方会の論文
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