RESUMO
We report a case of an inflammatory variant of epidermolysis bullosa acquisita in a 53-year-old male, with itching blistering eruption on the trunk, armpits and limbs for six months. The skin biopsy specimen showed subepidermal blister with neutrophils. Direct immunofluorescence revealed linear depositions of IgG, IgA, IgM and C3 at the basement membrane; indirect immunofluorescence and salt Split Skin were negative. Antinuclear antibodies were also negative. Improvement of the blisters followed treatment with systemic corticotherapy and some lesions healed with milia. This is a rare presentation of epidermolysis bullosa acquisita, with inflammatory lesions at first.
Assuntos
Epidermólise Bolhosa Adquirida/patologia , Penfigoide Bolhoso/patologia , Pele/patologia , Anti-Inflamatórios/uso terapêutico , Biópsia , Diagnóstico Diferencial , Epidermólise Bolhosa Adquirida/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Penfigoide Bolhoso/tratamento farmacológico , Prednisona/uso terapêuticoRESUMO
Apresenta-se caso de epidermólise bolhosa adquirida inflamatória. Paciente do sexo masculino, 53 anos, há seis meses com erupção vesicobolhosa pruriginosa sobre base eritematosa no tronco, axilas e membros. O exame anatomopatológico mostrou bolha subepidérmica com neutrófilos. A imunofluorescência direta revelou depósitos lineares de IgG, IgA, IgM e C3 na zona da membrana basal, sendo a imunofluorescência indireta e o Salt Split Skin indireto negativos. Anticorpos antinucleares não reagentes. Houve melhora do quadro com prednisona e cicatrização de algumas lesões com formação de milia. Trata-se de apresentação rara de epidermólise bolhosa adquirida, com lesões iniciais predominantemente inflamatórias.
We report a case of an inflammatory variant of epidermolysis bullosa acquisita in a 53-year-old male, with itching blistering eruption on the trunk, armpits and limbs for six months. The skin biopsy specimen showed subepidermal blister with neutrophils. Direct immunofluorescence revealed linear depositions of IgG, IgA, IgM and C3 at the basement membrane; indirect immunofluorescence and salt Split Skin were negative. Antinuclear antibodies were also negative. Improvement of the blisters followed treatment with systemic corticotherapy and some lesions healed with milia. This is a rare presentation of epidermolysis bullosa acquisita, with inflammatory lesions at first.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Epidermólise Bolhosa Adquirida/patologia , Penfigoide Bolhoso/patologia , Pele/patologia , Anti-Inflamatórios/uso terapêutico , Biópsia , Diagnóstico Diferencial , Epidermólise Bolhosa Adquirida/tratamento farmacológico , Penfigoide Bolhoso/tratamento farmacológico , Prednisona/uso terapêuticoRESUMO
The authors report the case of a 47-year-old female patient with dispersed ulcerated skin lesions that appeared 7 years before medical follow-up. Histopathological and endoscopic findings of such lesions led to the diagnosis of a rare disorder: metastatic Crohn's disease. This diagnosis is even more relevant because there is no case report in the literature of Crohn's disease restricted to cutaneous lesions, without major gastro-intestinal complaints.