engleski

Psoriasis vulgaris as a diagnostic problem in a patient with m yasthenia gravis. Case report.

A 51-year-old women suffered from myasthenia gravis for 20 years presented with psoriasiform, mildly infiltrated erythematosquamous plaques on her extremities and the upper part of her back, associated with tiredness and general malaise. First histological analysis could not confirm psoriasis vulgaris. The patient had undergone the UVB phototherapy with no improvement. Laboratory tests revealed positive antinuclear antibodies (ANA) in a titer 1:2, 560 and positive extractable nuclear antigens (ENA). According to these parameters, clinical findings and the course of the disease (photosensitivity), differential diagnosis included subacute lupus erythematosus. This was not confirmed by a second histological analysis (nonspecific inflammatory changes).Direct immunofluorescence of the affected skin showed linear deposits of C3 in the basement membrane zone and nuclear deposits of IgA in the epidermis. HLA-B8 was detected. Finally, third biopsy revealed the histological findings typical for psoriasis vulgaris.

psoriasis vulgaris; myasthenia gravis; diagnosis

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