中华皮肤科杂志 ›› 2020, Vol. 53 ›› Issue (5): 368-370.doi: 10.35541/cjd.20190525

• 临床经验 • 上一篇    下一篇

A型肉毒毒素治疗家族性良性天疱疮二例

唐佳    石滢    周俊峰    陈瑶    李珊山   

  1. 吉林大学第一医院皮肤科,长春  130021
  • 收稿日期:2019-04-24 修回日期:2019-12-30 发布日期:2020-04-30
  • 通讯作者: 李珊山 E-mail:shansalee@163.com

Two cases of familial benign pemphigus treated with botulinum toxin type A

Tang Jia, Shi Ying, Zhou Junfeng, Chen Yao, Li Shanshan   

  1. Department of Dermatology, The First Hospital of Jilin University, Changchun 130021, China
  • Received:2019-04-24 Revised:2019-12-30 Published:2020-04-30
  • Contact: Li Shanshan E-mail:shansalee@163.com

摘要: 【摘要】 首次采用注射A型肉毒毒素治疗2例经常规治疗疗效欠佳的家族性良性天疱疮患者。例1男,64岁,双侧腋下、腹股沟红斑、糜烂2年,于右腋下、右腹股沟各注射50 U A型肉毒毒素;例2女,33岁,双侧腋下、腹股沟、右腰部红斑、水疱9年,于左腋下、右腰部、双侧腹股沟各注射25 U A型肉毒毒素。2例患者注射后1周停止出汗,2周后皮损逐渐缓解。例1注射后1个月,双侧腋下及腹股沟红斑、糜烂基本消退,仅见轻度色素沉着,皮损基本痊愈,继续随访18个月,皮损无复发。例2注射后6周,注射处皮损大部分消退,遗留片状色素沉着,无明显新发皮损,继续随访10个月,皮损少量复发,外用糖皮质激素软膏后症状缓解。

关键词: 天疱疮, 良性家族性; 肉毒杆菌毒素类, A型; 注射, 皮下; 治疗

Abstract: 【Abstract】 Botulinum toxin type A was firstly used to treat two patients with familial benign pemphigus, who showed poor response to conventional therapies. Case 1, a 64-year-old male patient, presented with erythema and erosions on the bilateral axillary and inguinal regions for 2 years, and was injected with botulinum toxin type A at a dose of 50 U in the right axillary fossa and right groin separately. Case 2, a 33-year-old female patient, presented with erythema and blisters on bilateral axillary and inguinal regions and the right waist for 9 years, and was injected with botulinum toxin type A at a dose of 25 U in the left axillary fossa, right waist and bilateral groins separately. After the injection of botulinum toxin type A, sweating was inhibited in the 2 patients within 1 week, and skin lesions were gradually attenuated within 2 weeks. One month after the injection, erythema and erosions on the bilateral axillary and inguinal regions mostly regressed in the case 1, only mild hyperpigmentation was observed, and the patient was nearly cured. No recurrence was observed in the case 1 during 18-month follow-up. Six weeks after the injection, most of the skin lesions regressed in the case 2, only patchy hyperpigmentation was observed, and no obvious new lesions occurred. A few lesions recurred in the case 2 during 10-month follow-up, but were attenuated after the treatment with topical glucocorticoids.

Key words: Pemphigus, benign familial, Botulinum toxins, type A, Injections, subcutaneous, Treatment