天疱疮患者的Covid-19病例报告

Nandya Dwizella, Nevristia Pratama
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摘要

背景:天疱疮疾病,尤其是寻常型天疱疮(Pemphigus Vulgaris, PV)是一种自身免疫性疾病,由于自身抗体攻击桥粒蛋白(DSG) 1和3,导致皮肤和粘膜出现水疱。PV的自身免疫发展可能是特发性的,也可能是由肿瘤、药物、感染或炎症过程诱导的。除了影响呼吸道外,COVID-19还可能影响其他系统,如皮肤。自身免疫性疾病的发病机制与COVID-19有相似之处,都是免疫系统的过度反应。目的:报道1例PV自身免疫性疾病与COVID-19的相关性。病例:一名30岁女性,表现为全身疼痛和溃疡。皮肤病变前3天,患者有轻微咳嗽,SARS-CoV-2检查呈阳性。患者接受全身和局部皮质类固醇以及广谱抗病毒药物治疗。患者在治疗第5天病变情况改善,SARS-CoV-2 PCR阴性出院。讨论:长期的病毒感染或病毒感染本身,如COVID-19,可引起免疫系统失调,导致自身免疫性皮肤病变,其机制不同。在自身免疫性疾病中使用皮质类固醇或免疫抑制剂会增加在大流行中感染COVID-19的风险。结论:在2019冠状病毒病大流行中,2019冠状病毒病与寻常型天疱疮等自身免疫性疾病存在免疫失调导致皮肤病变相关
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Covid-19 In A Patient With Pemphigus: A Case Report
Background: Pemphigus disease, especsially Pemphigus Vulgaris (PV), is an autoimmune disease resulting in blisters on the skin and mucosa due to autoantibodies attacking desmogleins (DSG) 1 and 3. Autoimmunity development in PV may be idiopathic or induced by neoplasms, drugs, infections, or inflammatory processes.  Besides affecting the respiratory tract, COVID-19 may also affect other systems, such as the skin. The pathogenesis of autoimmune diseases and COVID-19 have similarities, which is an overreaction of the immune system. Purpose: To report a case about the association between PV autoimmune disease and COVID-19. Case: A 30-year-old woman presented with full-body pain and ulcers. Three days before the skin lesions, the patient complained of a mild cough, and the SARS-CoV-2 examination was positive. The patient was treated with systemic and topical corticosteroids along with broad-spectrum antivirals. The patient was discharged with an improved lesion condition and a negative SARS-CoV-2 PCR on day 5 of treatment. Discussion: Prolonged viral infection or viral infection itself, such as COVID-19 can cause immune system dysregulation leading to autoimmune skin lesions with different mechanisms. The use of corticosteroids or immunosuppressants in autoimmune diseases increases the risk of COVID-19 infection in a pandemic. Conclusion: In the COVID-19 pandemic, COVID-19 and autoimmune diseases such as pemphigus vulgaris are interrelated with the presence of immune dysregulation leading to skin lesions
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