中国麻风皮肤病杂志 ›› 2026, Vol. 42 ›› Issue (4): 265-269.doi: 10.12144/zgmfskin202604265

• 临床研究 • 上一篇    下一篇

三例不同临床表现的抗p200类天疱疮临床分析

李昕,万苗,游霞,朱建建   

  1. 中南大学湘雅医学院附属常德医院(常德市第一人民医院)皮肤性病科,湖南常德,415000
  • 出版日期:2026-04-15 发布日期:2026-04-07

Clinical analysis of three cases of anti-p200 pemphigoid with diverse manifestations

LI Xin, WAN Miao, YOU Xia, ZHU Jianjian   

  1. Department of Dermatology, Changde Hospital, Xiangya School of Medicine, Central South University(the First People's Hospital of Changde City), Changde 415000, China
  • Online:2026-04-15 Published:2026-04-07

摘要: 目的:总结抗p200类天疱疮患者的临床特点及诊疗情况。方法:收集3例确诊为抗p200类天疱疮的患者资料,回顾性分析其临床特点、实验室特征及诊疗情况。结果:3例抗p200类天疱疮患者中,女1例,男2例,分别表现为大疱性类天疱疮样、线状IgA大疱性皮病样及湿疹样损害,均伴黏膜受累及瘙痒。组织病理示表皮下水疱伴有不同程度的中性粒细胞、嗜酸性粒细胞及淋巴细胞浸润。直接免疫荧光(DIF)显示基底膜带 IgG、C3线状沉积,盐裂皮肤-间接免疫荧光(ss-IIF)提示血清IgG抗体结合于盐裂皮肤真皮侧。治疗分别采用糖皮质激素单药、糖皮质激素联合甲氨蝶呤、多西环素联合烟酰胺。随访1个月3 例患者病情均得到控制,2 例随访至1年时完全缓解停药且未复发,1例仍在随访中,病情稳定。结论:抗p200类天疱疮临床表现多样,其诊断需要结合组织病理、DIF、ss-IIF及免疫印迹法,治疗应遵循个体化原则。

关键词: 抗p200类天疱疮, 类天疱疮, 大疱性

Abstract: Objective: To summarize the clinical characteristics, diagnosis and treatment of patients with anti-p200 pemphigoid. Methods: Clinical data of 3 patients diagnosed with anti-p200 pemphigoid were collected, and a retrospective analysis was conducted on their clinical manifestations, laboratory characteristics, diagnosis and treatment regimens. Results: Among the 3 patients with anti-p200 pemphigoid, there were 1 female and 2 male cases. The clinical manifestations were bullous pemphigoid-like, linear IgA bullous dermatosis-like and eczematous lesions, respectively. All patients presented with mucosal involvement and pruritus. Histopathological examination revealed subepidermal blisters with varying degrees of infiltration by neutrophils eosinophils, and lymphocytes. Direct immunofluorescence (DIF) showed linear deposition of IgG and C3 along the basement membrane zone. Salt-split indirect immunofluorescence (ss-IIF) revealed that serum IgG antibodies bound to the dermal side of salt-split skin. The patients were treated with glucocorticoids alone, glucocorticoids combined with methotrexate and doxycycline combined with nicotinamide, respectively. All 3 patients achieved disease control at the 1-month follow-up; 2 patients achieved complete remission and discontinued treatment with no recurrence at the 1-year follow-up, and 1 patient was under follow-up with stable disease status. Conclusions: Anti-p200 pemphigoid exhibits diverse clinical manifestations. Its diagnosis requires integration of histopathology, DIF, ss-IIF and immunoblotting, and individualized treatment regimens should be adopted for clinical management.

Key words: anti-p200 pemphigoid, pemphigoid, bullous