Compare of most common type 天皰瘡 & 類天皰瘡
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Pemphigus vulgaris |
Bullous pemphigoid |
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Suprabasal epi. Cleft 表皮內 |
Subepidermal epi. Cleft 表皮下 |
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PE |
Nikolsky’s sign(+)~拿棉棒推水泡推得動,表示很淺層 |
Nikolsky’s sign(-) |
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Antigen |
Dsg3(主), Dsg1, Acantholytic |
BP1(BP230), BP2(BP180) lamina lucida |
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DIF |
Intercellular IgG, C3 Ab |
Linear C3, IgG Ab along DEJ |
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Age |
50-60 Y/O |
Elderly |
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S/S |
Superficial flaccid blister, involve skin and mucosa Erosion/ulcer of oral mucosa |
Large tense bullae Symmetric, no mucosa involvement, flexure region |
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Prognosis |
Poor |
Good |
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1st line treatment |
Systemic steroid |
Systemic steroid |
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Dermatitis Herpetiformis |
Pemphigus Foliaceus |
Paraneoplastic Pemphigus |
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S/S |
Chronic diarrheaà Gluten sensitivity 群聚性水泡,很癢,多在四肢伸側,背部 Oral mucosa normal |
Seborrhic area Rare mucosal involve |
Intractable painful mucosal erosion Polymorphic skin rash |
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DIF |
Granular IgA deposit papillary dermis |
Intercellular IgG, Dsg1 Subcorneal separation |
Intercellular IgG, C3 Ab (如pemphigus) Granular to linear C3 deposit on BMZ (如pemphigoid) |
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Others |
Dapsone treatment |
比PV還淺 |
Cancer-Non-HD lymphoma, CLL |
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