Three cases of trauma-triggered autoimmune bullous skin diseases

Abstract

Objective To summarize clinical and histopathological features of trauma-triggered autoimmune bullous skin diseases, and to explore its possible pathogenesis. Methods Clinical manifestations, histopathological features and treatment of 3 cases of trauma-triggered pemphigus or pemphigoid were analyzed, and summarized according to related domestic and overseas literature. Results Of the 3 cases, 1 was a female aged 62 years, and 2 were males aged 60 and 71 years respectively. They all had a history of skin trauma or surgery before the onset of the diseases, and time intervals from trauma to diseases were 5, 5 weeks and 3 days respectively. The 3 cases were diagnosed as bullous pemphigoid (anti-BP180 antibody 109 U/ml, anti-BP230 antibody negative) , pemphigus vulgaris (anti-Dsg1 antibody 68.8 U/ml, anti-Dsg3 antibody 219 U/ml) and pemphigus foliaceus (anti-Dsg1 antibody 143 U/ml, anti-Dsg3 antibody negative) respectively. Their lesions were relieved dramatically after oral and (or) topical glucocorticoid treatment. Conclusions Trauma may be a triggering factor for autoimmune bullous skin diseases. For patients with post-traumatic poor wound healing or skin erythema, blisters and erosion, which can hardly be attributed to trauma or surgery itself, autoimmune bullous skin diseases should be considered, and histopathological or immunopathological examinations should be performed timely. Key words: Pemphigus; Pemphigoid, bullous; Wounds and injuries