Trauma-induced pemphigus: a case series of 36 patients
Trauma-induced pemphigus: a case series of 36 patients
复制标题
DOI：
10.1111/ddg.12738
复制
发表时间：
2016-02-01
影响因子：
3.6
通讯作者：
Chams-Davatchi, Cheyda
中科院分区：
文献类型：
--
作者：
Daneshpazhooh, Maryam;Fatehnejad, Mina;Chams-Davatchi, Cheyda
背景和目的：天疱疮是一组以表皮内棘细胞松解性水泡为特征的自身免疫性疾病。同构反应，或科布纳现象(KP)，定义为创伤后疾病的典型损害的表现，在天疱疮中很少报道。我们的目的是介绍由于皮肤创伤而出现新的天疱疮皮损的患者。患者和方法：回顾1999-2013年间来自自身免疫性大疱性疾病研究中心的天疱疮患者的医疗档案，这些患者在疾病发生或发作之前有创伤史。13名患者出现了新发的PV，另外23名患者之前被诊断为PV。天疱疮病变最常发生在大手术后，包括腹部、矫形和胸部手术，以及牙科手术、钝性物理创伤和皮肤手术。此外，后发性白内障激光手术、烧伤、放射治疗和物理治疗也可诱发天疱疮。创伤至病变的平均时间：复发PV为4.7周，新发PV为15.0周。结论：天疱疮患者应避免不必要的手术和钝性创伤。此外，创伤后天疱疮应该被怀疑是手术伤口愈合不良的原因，必须进行确认性活检。
Background and objectives: Pemphigus is a group of autoimmune diseases characterized by intraepidermal acantholytic blisters. Isomorphic responses, or Koebner phenomenon (KP), defined as the appearance of typical lesions of a disease following trauma are rarely reported in pemphigus. Our aim was to present patients who developed new pemphigus lesions as a result of skin trauma.Patients and methods: The medical files of pemphigus patients from the Autoimmune Bullous Diseases Research Center, who had a history of trauma before the onset or flare of their disease, between 1999 and 2013 were reviewed.Results: Thirty-six pemphigus vulgaris (PV) patients had a history of trauma. Thirteen patients developed new-onset PV and the other 23 had previously been diagnosed with PV. Pemphigus lesions developed most often following major surgeries including abdominal, orthopedic, and chest surgeries as well as dental procedures, blunt physical trauma, and skin surgeries. Moreover, post-cataract laser surgery, burns, radiation therapy, and physiotherapy were also shown to induce pemphigus. Mean time between trauma and lesions was 4.7 weeks for recurrent PV and 15.0 weeks for new-onset PV.Conclusions: Unnecessary surgery and blunt trauma should be avoided in pemphigus patients. Furthermore, posttraumatic pemphigus should be suspected in poorly healing surgical wounds and confirmatory biopsies are mandatory.