case_images: PMC9464440_01
case_images: (A-C) The patient with diffuse infiltrative erythema and scaling lesion involving more than 90% of the total body surface area. (B) Co-localization of psoriatic plaques and tense vesicles and blisters distributed on her trunk, limb, and axillary, some of bullae rupture and leave an eroded base. (C) lower legs with hypertrophic lichen planus-like lesions with silvery-white scales and scratch.
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case_images: Area and Severity Index (PASI) score was 29.8 (Figure 1). Abdominal ultrasound examination indicated fatty liver disease.
case_images: (A and B) Hyperkeratosis, parakeratosis, Munros microabscess, hypogranulosis, and acanthosis as well as congested and dilated blood vessels in the superficial dermis. Subepidermal blister under the psoriatic hyperplasia epidermal, serous and inflammatory cells including more eosinophils cells in the blister (Hematoxylin-eosin stained.). (A) Original magnification x100, (B) Original magnification x200.
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case_images: IU/mL), and uric acid (397 micromol/L), but the other results were normal. Biopsy analysis demonstrated Munro's microabscess, subepidermal blister under the psoriatic hyperplastic epidermis, and serous and inflammatory cells (including more eosinophils cells) in the blister (Figure 2).
case_images: Clinical manifestations after 2 weeks of treatment: (A) Clinical remission of both pemphigoid and psoriatic lesions. (B) Diffuse erythema and scaling clearly subsided. (C) Hyperpigmentation and lichen planus-like lesions, infiltrations, scaling of Bilateral calf improvement.
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case_images: After 2 weeks, significant improvement of both BP and EP lesion was noted (Figure 3), blisters and vesicles have largely subsided, the PASI score of post-treatment was 1.6.