A Case of Bullous Pemphigoid with Severe Pruritus and Elevated Serum IgE Level.
- Author:
Jae Wook KIM
1
;
Jee Bum LEE
;
Seong Jin KIM
;
Seung Chul LEE
;
Young Ho WON
Author Information
1. Department of Dermatology, Chonnam National University Medical School, Kwangju, Korea. yhwon@chonnam.chonnam.ac.kr
- Publication Type:Case Report
- Keywords:
Bullous pemphigoid;
IgE;
pruritus
- MeSH:
Aged;
Autoantibodies;
Autoimmune Diseases;
Azathioprine;
Blister;
Eosinophilia;
Female;
Fluorescent Antibody Technique, Direct;
Follow-Up Studies;
Hemidesmosomes;
Humans;
Immunoblotting;
Immunoglobulin E*;
Immunoglobulin G;
Middle Aged;
Pemphigoid, Bullous*;
Pruritus*;
Skin
- From:Korean Journal of Dermatology
2002;40(2):170-173
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Bullous Pemphigoid(BP) is a chronic non-hereditary autoimmune disease of the elderly characterized by subepidermal blisters due to autoantibodies targeted to hemidesmosome. An elevated serum IgE level and perepheral blood eosinophilia are observed in one-half of cases though their clinical relevance on disease activity is unclear. A 48-year-old woman presented with severe pruritus and recently developed multiple bullae. IgG antibody was deposited on the epidermal roof side on direct immunofluorescence study and 180 & 230 kD BP antigens were identified with immunoblotting analysis. Pruritus was so severe as not to be controlled by conventional antihistamine therapy, and serum IgE level was highly elevated during the intensely itching period. However, it dropped gradually with improvement of skin lesions and pruritus in response to systemic corticosteroid and azathioprine. This finding suggests a long-term follow-up of IgE levels is necessary to determine the disease activity in a peculiar BP.
