系統性紅斑性狼瘡水疱樣疹以Dapsone治療之病例報告

Bullous Eruption of Systemic Lupus Erythematosus

一位系統性紅斑性狼瘡患者，在面及耳後部併發一種不痛不癢的水疱樣疹，以大劑量類固醇治療無效，且不斷蔓延惡化。組織切片顯示在表皮、真皮交界處有水解現象，表皮下有少量中性球及嗜伊紅球浸潤，且血管周圍有單核球浸潤。因此皮膚病灶對類固醇治療毫無反應，且其組織病理變化類似疱疹樣皮膚炎(Dermatitis Herpetiformis)，乃以dapsone治療，其結果令人相當滿意。Dapsone的迅速療效，對併發於系統性紅斑性狼瘡的水疱樣疹，實乃一可供選擇的有效治療藥物。

One patient with systemic lupus erythematosus developed a nonprutic vesiculobullous eruption that was unresponsive to high-dose corticosteroid therapy. Biopsy results showed liquification with neutophil and eosinophils infiltratio.n over epidermal and dermal junction, perivascular lymphohistiocyte infiltrated also were noted. Due to the unresponsiveness to corticosteroid therapy and the striking histologic resemblance to dermatitis herpetiformis, the patient was treated with dapsone. Within 24 hours the patient had prompt cessation of the appearance of new lesions The rapid response to dapsone therapy suggests that dapsone is useful in treating bullous lesions af systemic lupus erythematosus.