寻常型银屑病合并落叶型天疱疮1例OA

A 50-year-old man presented with red papules,plaques,and desquamation for 15 years,as well as vesicles and desquamation for the past 25 days.He was diagnosed with psoriasis vulgaris a month ago and was treated with a subcutaneous injection of secukinumab at 300 mg weekly for 4 weeks.New vesicles and desquamation appeared on the trunk and limbs 25 days ago.A pemphigus antibody test showed Dsg1 at 222.76 U/mL,with Dsg3 and BP180 results negative.Histopathological examination showed focal parakeratosis with Munro microabscesses,as well as acantholytic cells in the superficial epidermis.Direct immunofluorescence revealed intercellular IgG(+++)and C3(++)between epidermal prickle cells.Diagnosis:Psoriasis vulgaris and pemphigus foliaceus.Treatment with prednisone and methotrexate for 11 weeks resulted in signifi-cant improvements in erythema,vesicles,and desquamation.