1.Localized Epidermolysis Bullosa Acquisita Limited to the Face.
Myung Hoon LEE ; Ji Young YOO ; You Bum SONG ; Moo Kyu SUH ; Tae Jung JANG ; Soo Chan KIM
Korean Journal of Dermatology 2013;51(12):990-991
No abstract available.
Epidermolysis Bullosa Acquisita*
;
Epidermolysis Bullosa*
2.Epidermolysis Bullosa Acquisita: A Complete Remissions versus Patients with Long-term Persistent Activities.
Dong Kyu HWANG ; Chang Woo LEE
Korean Journal of Dermatology 1999;37(6):715-718
BACKGROUND: In epidermolysis bullosa acquisita, it has been recognized that there exists heterogeneity in the clinical and serologic/immunopathologic features. OBJECTIVE: We examined patients with epidermolysis bullosa acquisita to see if there were any associated clinical and serological features which may predict disease activity or prognosis in the disease. METHODS: Clinical and some serologic features were compared. between 2 groups of patients with epidermolysis bullosa acquisita; one with complete remission of the symptoms and signs of the disease for more than 2 years and the other group with persistent disease activities of longer than 5 years.
Epidermolysis Bullosa Acquisita*
;
Epidermolysis Bullosa*
;
Humans
;
Population Characteristics
;
Prognosis
3.Epidermolysis Bullosa Pruriginosa in a 12-year-old male: A case report
Agustin Miguel P. Soriano ; Mae Ramirez-Quizon
Journal of the Philippine Medical Association 2024;102(2):81-88
Introduction:
Epidermolysis Bullosa Pruriginosa (EBP) is a rare subtype of the inherited Dystrophic ~ Epidermolysis Bullosa spectrum of diseases and results from a gene mutation in COL7AL Though predominantly an autosomal dominant disease, autosomal recessive and even sporadic have been reported.
Case Summary:
Case Summary:We report a case of a 12-year-old Filipino male presenting with a chronic history of numerous scratching-induced blisters predominantly distributed on the extensor aspect of his arms and legs without concomitant oral lesions, nail dystrophy, or hair findings, and without a family history of similar lesions. Histopathologic assessment, Direct Immunofluorescence (DIF), and Indirect Immunofiuorescence (IIF) showed a subepidermal split with scant inflammatory infiltrates, no immunofluorescence, and absent userrated linear immunofluorescence at the dermal-side of the Salt Split Skin slide, respectively, which were all consistent with EBP. Enzyme-Linked Immunosorbent Assay (ELISA) for Anti-Collagen VII antibodies was slightly elevated, which may suggest an alternative diagnosis of Epidermolysis Bullosa Acquisita (EBA). This slight elevation may be due to the mutated Collagen Vil protein becoming antigenic and therefore provoking an immune response. To conclusively distinguish EBP from EBA, a COL7AI gene mutation analysis was recommended. With a diagnosis of EBP cannot totally rule out EBA, the patient was initially managed with dapsone monotherapy, counseled regarding behavioral modification to reduce scratching and trauma, advised wound care and close monitoring for the development of oropharyngeal lesions, and recommended for COL7A1 genetic mutation analysis.
Conclusion
This report demonstrates a case of EBP
with elevated Anti-Collagen VII antibodies. The
diistinction between EBP and EBA is important
because this changes the management: EBP is
largely supportive, while EBA may benefit from
immunosuppressive therapy.
Epidermolysis Bullosa Pruriginosa
;
Enzyme-Linked Immunosorbent Assay
;
Epidermolysis Bullosa Acquisita
4.Successful Treatment of Localized Epidermolysis Bullosa Acquisita with Low-dose Dapsone and Topical Tacrolimus.
Mi Ri KIM ; Sang Eun LEE ; Soo Chan KIM
Korean Journal of Dermatology 2009;47(9):1090-1093
A 52-year-old man had a twenty-five year history of recurrent bullous eruption that was localized to both cheeks. The diagnosis of epidermolysis bullosa acquisita was confirmed by means of direct immunofluorescence and salt-split direct immunofluorescence studies that were performed on the perilesional skin. The patient has been in partial remission state with the treatment of low dose dapsone (12.5~25 mg) and topical tacrolimus. Herein, we report on a case of EBA localized to the face, and it showed a favorable response to treatment with low-dose dapsone and topical tacrolimus.
Cheek
;
Dapsone
;
Epidermolysis Bullosa
;
Epidermolysis Bullosa Acquisita
;
Fluorescent Antibody Technique, Direct
;
Humans
;
Middle Aged
;
Skin
;
Tacrolimus
5.A Case of Epidermolysis Bullosa Acquisita.
Mi Sook CHANG ; Dae Sung LEE ; Yung Whan KIM ; Won HOUH ; Chang Woo LEE
Korean Journal of Dermatology 1988;26(4):581-586
We report a case of epidermolysis bullosa acquisita in a 53 year-old woman who had. extreme skin fragility, trauma induced blisters and erosions usually localized to extensor site of the skin surface, and healing with scars and milia for several years. Histologic findings of perilesional skin showed normal epidermis, subepid malblister and spirsely infiltration of inflammatory cells. Direct immuncofluorescence showed depositiori of IgCi and C3 in a linear pattern along the epidermal basement, membrane in the per ilesional skin. In indirect immuriofluorescence, using 1.0M sodium chloride separated nor mal human skin as the sntbstrate, antitodies(IgG at a titer of 1:40) were bound to dermal site of the separation, indicating that the patient serum yields the reaction in or below the lamiria densa. Electronmicroscopic findings showed the roof of the blister was located. below the basal lamiria.
Blister
;
Cicatrix
;
Epidermis
;
Epidermolysis Bullosa Acquisita*
;
Epidermolysis Bullosa*
;
Female
;
Humans
;
Membranes
;
Middle Aged
;
Skin
;
Sodium Chloride
6.A Case of Epidermolysis Bullosa Acquisita.
Sang Chin LEE ; Jun Young LEE ; Yung Hwang KIM ; Chung Won KIM
Annals of Dermatology 1992;4(2):120-123
We report a case of epidermolysis bullosa acqumta with characteristic clinical features, subepidermal vesicles in histopathology, and deposits of IgG in basement membrane zone at routine direct immunofluorescent test. 1M NaCl-treated immunofluorescent test was performed in order to correctly diagnose our case. In this method, linear immunofluorescent deposits of IgG were found only at the dermal part of separation induced by 1M NaC1 treatment to skin specimen.
Basement Membrane
;
Epidermolysis Bullosa Acquisita*
;
Epidermolysis Bullosa*
;
Immunoglobulin G
;
Methods
;
Skin
7.Treatment conundrum: A case of recalcitrant Epidermolysis Bullosa Acquisita (EBA) in a 50-year-old Filipino male
Danelle Anne L. Santos, MD ; Aira Monica R. Abella, MD ; Danica-Grace Tungol, MD, DPDS ; Leilani R. Senador, MD, FPDS
Journal of the Philippine Dermatological Society 2023;32(1):31-34
Introduction:
Epidermolysis Bullosa Acquisita (EBA) is a rare autoimmune blistering disease which presents in the skin and mucous
membranes. The decrease in anchoring fibrils in the basement membrane zone causes separation of the epidermis from the dermis,
resulting in its blistering presentation. The treatment plan will depend on the severity of the disease. The first-line treatment for mild
EBA includes topical corticosteroids and immunomodulators such as dapsone and colchicine; while severe cases of EBA may be given
intravenous immunoglobulins, systemic steroids, and immunosuppressants such as azathioprine and cyclophosphamide.
Case Report:
This is a case of a 50-year-old Filipino male who presented with a 2-year history of vesicles and tense bullae which evolved
into papules, plaques and erosions with scarring and milia formation on the scalp and trauma-prone areas of the trunk and extremities.
Clinical examination revealed multiple, well-defined, irregularly shaped erythematous papules and plaques with crusts, scales, erosions, pearl-like milia and scarring on the chest, back, upper, and lower extremities. The oral mucosa was moist with some ulcers on the
tongue. Histopathologic examination using Hematoxylin and Eosin (H&E) stain revealed the absence of the epidermis with retention of
dermal papillae suggestive of subepidermal clefting. Further examination with direct immunofluorescence (DIF) revealed monoclonal
immunoglobulin (IgG) deposits demonstrating an intense linear fluorescent band at the dermoepidermal junction, consistent with Epidermolysis Bullosa Acquisita. Overall, the combined administration of prednisone, azathioprine, and colchicine resulted only in transient
and incomplete resolution of lesions in this case of EBA.
Conclusion
The management of EBA is mostly supportive with the goal of minimizing complications. Combination treatments using
steroids, colchicine, and azathioprine have been reported with various results. Its management remains challenging as most cases are
refractory to treatment.
Epidermolysis Bullosa Acquisita
;
bullous disease
;
azathioprine
;
colchicine
;
prednisone
8.A Case of Epidermolysis Bullosa Acquisita (Cicatricial pemphigoid-like type).
Taek Hwan CHON ; Soon Cheol KIM ; Hong Yong KIM ; Han Uk KIM ; Chull Wan IHM
Korean Journal of Dermatology 2000;38(6):793-797
Epidermolysis bullosa acquisita (EBA) is an uncommon autoimmune subepidermal blistering disorder and has four clinical subtypes. Among the four types of EBA, the cicatricial pemphigoid-like type is rarer than the other types and clinically the worst one. We experienced a case of cicatricial pemphigoid-like type of EBA in a 69-year-old woman, whose initial symptom was painful erosive lesions of oral mucous membrane before development of ocular and bullous cutaneous lesions. The clinical, histopathological findings and immunoblot assay were all typical of the disease. The course of her disease showed remissions by treatments including corticosteroid and intravenous immunoglobulin, but each time with exacerbations.
Aged
;
Blister
;
Epidermolysis Bullosa Acquisita*
;
Epidermolysis Bullosa*
;
Female
;
Glycogen Storage Disease Type VI
;
Humans
;
Immunoglobulins
;
Mucous Membrane
9.A Study of Fluorescence Pattern of Immune Deposits in Bullous Pemphigoid and Epidermolysis Bullosa Acquisita.
Korean Journal of Dermatology 1994;32(4):626-630
Backgraund : Most of the inflammatory bullous lesions in bullous pamphigoid(BP) and epidermolysis bullosa acquisite(EBA) demonstrate similar clinical and histological features. However, the specificities of the autoantibodiea reactive to the dermo-epidermal junction antigeins are different. In these two bullouk dermat loses, there are no remarkable differences in symptomaiology, there are no unique predilection sites for the lesions and they do not usually leave scars after nvolution. Considering these similarities, dermatologists could encounter some clinical confuiion in maling a provisional diagnosis. OBJECTIVE: Authors examined three patients of BP with classic inflammatory bullous eruptions and threa patients of EBA with inflammatory bullous lesions to see if here were any differences in the morphology of the immuno-fluorescence(IF) pattern. METHODS: For direct IF of vertical or semi-vertical sections, perilasional skin was obtained in each patient for indirect IF of horizontal or semi-horizonta1 sections, Ig(bound substrates were prepared from all these autoantibody-positive individuals. All specimens veri; observed at 200/400-magnification fields through an ordinary fluorescence microscopy. RESULTS: Patterns of fluorescence observed by direct IF were characterized as thin-linear in BP and thick/coarse-linear in EBA along the basement membrane zone. On the horizontal section preparations in indirect IF, the patterns of fluorescence were clean-linear in E3P hnd more fluffy-linear in EBA at the dermoepidermal junction, These patterns could be recognized aim/larly in the fields of both 200 and 400-magnification, however each minor differences were not easy to distinguish each other. CONCLUSION: The above findings of subtle differences in the pattern of IF may provide some suggestions to the examiners for the need of differential diagnosis in theae riseases.
Basement Membrane
;
Blister
;
Cicatrix
;
Diagnosis
;
Diagnosis, Differential
;
Epidermolysis Bullosa Acquisita*
;
Epidermolysis Bullosa*
;
Fluorescence*
;
Humans
;
Male
;
Microscopy, Fluorescence
;
Pemphigoid, Bullous*
;
Skin
10.A Study of Fluorescence Pattern of Immune Deposits in Bullous Pemphigoid and Epidermolysis Bullosa Acquisita.
Korean Journal of Dermatology 1994;32(4):626-630
Backgraund : Most of the inflammatory bullous lesions in bullous pamphigoid(BP) and epidermolysis bullosa acquisite(EBA) demonstrate similar clinical and histological features. However, the specificities of the autoantibodiea reactive to the dermo-epidermal junction antigeins are different. In these two bullouk dermat loses, there are no remarkable differences in symptomaiology, there are no unique predilection sites for the lesions and they do not usually leave scars after nvolution. Considering these similarities, dermatologists could encounter some clinical confuiion in maling a provisional diagnosis. OBJECTIVE: Authors examined three patients of BP with classic inflammatory bullous eruptions and threa patients of EBA with inflammatory bullous lesions to see if here were any differences in the morphology of the immuno-fluorescence(IF) pattern. METHODS: For direct IF of vertical or semi-vertical sections, perilasional skin was obtained in each patient for indirect IF of horizontal or semi-horizonta1 sections, Ig(bound substrates were prepared from all these autoantibody-positive individuals. All specimens veri; observed at 200/400-magnification fields through an ordinary fluorescence microscopy. RESULTS: Patterns of fluorescence observed by direct IF were characterized as thin-linear in BP and thick/coarse-linear in EBA along the basement membrane zone. On the horizontal section preparations in indirect IF, the patterns of fluorescence were clean-linear in E3P hnd more fluffy-linear in EBA at the dermoepidermal junction, These patterns could be recognized aim/larly in the fields of both 200 and 400-magnification, however each minor differences were not easy to distinguish each other. CONCLUSION: The above findings of subtle differences in the pattern of IF may provide some suggestions to the examiners for the need of differential diagnosis in theae riseases.
Basement Membrane
;
Blister
;
Cicatrix
;
Diagnosis
;
Diagnosis, Differential
;
Epidermolysis Bullosa Acquisita*
;
Epidermolysis Bullosa*
;
Fluorescence*
;
Humans
;
Male
;
Microscopy, Fluorescence
;
Pemphigoid, Bullous*
;
Skin