Pemfigoid nodülaris: bir olgunun klinikopatolojik analizi

Özet

Pemfigoid nodülaris, klinik olarak pruritik nodüller ve büllerle karakterize nadir bir büllöz pemfigoid varyant›d›r. Histopatolojik olarak prurigo özellikleri tafl›mas›na karfl›n immünofloresan incelemelerde büllöz pemfigoid benzeri depolanmalar›n saptand›¤› bu hastal›kta özellikle büllöz lezyonlar›n efllik etmedi¤i durumlarda tan›da güçlükler yaflanabilir. Biz 6 ayd›r vücutta yayg›n kafl›nt›s› ve prurigo papülleri olan, antihistamin ve topikal kortikosteroid tedavisine yan›t al›namayan 68 yafl›nda bir kad›n olguyu sunduk. Histopatolojik olarak prurigo nodülaris ile uyumlu bulgular saptanmas›na karfl›n, direkt immünofloresan incelemede bazal membran zonu boyunca lineer tarzda otoantikor depolanmalar› saptand›. Salt-split indirekt immünofloresan incelemede söz konusu otoantikor depolanmas›n›n ayr›flman›n tavan›nda oldu¤u tespit edildi. Pemfigoid nodülaris tan›s› konulan ve sistemik kortikosteroid tedavisine iyi yan›t veren olgunun klinikopatolojik analizi yap›lm›flt›r. (Turkderm 2007; 41: 133-5)

Abstract

Pemphigoid nodularis is a rare variant of bullous pemphigoid, clinically characterized by pruritic nodules and blisters. Diagnosis may be difficult particularly in non-bullous cases. Although it shows features of prurigo as histopathologically, bullous pemphigoid-like autoantibody depositions is determined by immunoflouresence examination. We described 68-year-old woman who presents with 6 month history of a widespread pruritus and pruritic papules, which had not responded to the treatment with antihistamines and topical corticosteroids. Despite histopathologic findings were identical to those of prurigo nodularis, bullous pemphigoid-like autoantibody depositions were observed in linear fashion at basal membrane zone by immunoflouresence examination. In salt-split indirect examination, this deposition was located at the epidermal side of split. A clinicopathologic analysis was done on the case that was diagnosed as pemphigoid nodularis and responded well to the treatment of systemic corticosteroid. (Turkderm 2007; 41: 133-5)