Psoriasisli Hastada Büllöz Pemfigoid Geliþimi ve Siklosporin ile Ortak Tedavi

Psoriasis ve büllöz pemfigoid birlikteliði daha önce bildirilmiþ olmakla beraber, oluþum mekanizmasý halen açýklýða kavuþmamýþtýr. Yirmi iki yýldýr plak psoriasisi olan 34 yaþýndaki kadýn hastada, hastaneye yatýþý sýrasýnda boyun ve üst ekstremitelerde yaygýn gergin büllöz lezyonlarýn geliþtiði gözlendi. Veziküler lezyondan alýnan biyopsinin histopatolojik incelemesinde subepidermal bül ve direkt immünofloresan incelemesinde bazal membran boyunca lineer tarzda IgG ve C3 birikimi saptandý. Psoriasis ve büllöz pemfigoid birlikteliðinde tedavide zorluklarla karþýlaþýlabilmesine raðmen hastamýzda her iki hastalýk da siklosporin ile baþarýlý bir þekilde tedavi edildi.

Bullous Pemphigoid in a Patient with Psoriasis Treated with Cyclosporine

The concomitant occurrence of psoriasis and bullous pemphigoid has been described previously, but the pathogenic mechanism of this relationship is still unknown. We describe a 34-year-old woman with a 22-year history of plaque-type psoriasis. On the third day of hospitalization, disseminated tense bullae developed on her neck and upper extremities. Histologic examination of biopsy specimen obtained from a vesicular lesion demonstrated a subepidermal blister. Direct immunofluorescence revealed IgG and C3 deposition in a linear pattern at the basement membrane zone. Both diseases were successfully treated with cyclosporine. However, the coexistence of these conditions represents a difficult therapeutic challenge.