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Aggressive Immunosuppressive Therapy for a Refractory Case of IgA Pemphigus
Kendall Sibley Hash, MD;
Adrienne Rencic, MD, PhD;
Maria Ines Hernandez, MD;
Takashi Hashimoto, MD;
H. Carlos Nousari, MD
Arch Dermatol. 2002;138:744-746.
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REPORT OF A CASE
A 70-year-old white woman presented to a local dermatology clinic with
a 2-month history of blisters that had begun in the mouth and had progressed
to involve the scalp and flexural areas, including the bilateral inframammary
regions and the groin. These flaccid bullae ruptured easily, producing painful
erosions. She was found to be otherwise healthy except for a long history
of hypertension and hypercholesterolemia, which were controlled with nifedipine,
quinapril hydrochloride, bisoprolol fumarate–hydrochlorothiazide, and
atorvastatin. She had been taking these medications for more than 2 years.
She denied any family history of similar eruptions or recent overseas travel.
Several mucocutaneous biopsy specimens had been obtained at another medical
center, including 2 from the gingiva, which revealed neutrophil-rich intraepithelial
and, in some areas, suprabasilar acantholytic blisters. However, the results
of direct and . . . [Full Text of this Article]
DIAGNOSTIC CHALLENGE
COMMENT
From the Johns Hopkins Medical Institutions, Baltimore, Md (Drs Sibley
Hash, Rencic, Hernandez, and Nousari), and Kurume University School of Medicine,
Kurume, Fukuoka, Japan (Dr Hashimoto).
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