We experienced a 40-year-old female patient who had vegetating plaques, erosions and a few vesicles on the external genitalia and the oral mucasa, assoeiated with pulmonary tuberculosis. On the skin biopsy specimen of the vegetating plaque, it showed acanthoais, papillomatosis, downward proliferation of the epidermis and eosinophilic microabacess in the epidermis. Direct immunofluorescence of the perilesional skin revealed deposition of IgG, Cq, Cs and C on the intercellular substance of the epidermis. Indirect immunofluorescence disclosed IgCi auto antibody(1: 320) positive to the inter ellular substance of the normal human back skin. The skin lesion had impraved with dapsone therapy.
Adult ; Biopsy ; Dapsone ; Eosinophils ; Epidermis ; Female ; Fluorescent Antibody Technique, Direct ; Fluorescent Antibody Technique, Indirect ; Genitalia ; Humans ; Immunoglobulin G ; Papilloma ; Pemphigus* ; Skin ; Tuberculosis, Pulmonary

This paper deals with a case of linear IgA bullous dermatosis (LABD). The patient was a 58-year-old woman who had multiple pruritic vesicles on the trunk, buttocks, thighs, tongue and buccal mucosa. A biopsy of a lesion revealed subepidermal vesicles. Direct immunofluorescence examination of the perilesional skin showed a linear deposition of IgA along the basement membrane zone (BMZ). Indirect immunofluorescence examination, using NaCl split skin as substrate, showed antiBMZ IgA antibodies bound only to the epidermal side. The skin lesions responded well to oral dapsone therapy.
Antibodies ; Basement Membrane ; Biopsy ; Buttocks ; Dapsone ; Female ; Fluorescent Antibody Technique, Direct ; Fluorescent Antibody Technique, Indirect ; Humans ; Immunoglobulin A ; Linear IgA Bullous Dermatosis* ; Middle Aged ; Mouth Mucosa ; Skin ; Thigh ; Tongue

This paper deals with a case of linear IgA bullous dermatosis (LABD). The patient was a 58-year-old woman who had multiple pruritic vesicles on the trunk, buttocks, thighs, tongue and buccal mucosa. A biopsy of a lesion revealed subepidermal vesicles. Direct immunofluorescence examination of the perilesional skin showed a linear deposition of IgA along the basement membrane zone (BMZ). Indirect immunofluorescence examination, using NaCl split skin as substrate, showed antiBMZ IgA antibodies bound only to the epidermal side. The skin lesions responded well to oral dapsone therapy.
Antibodies ; Basement Membrane ; Biopsy ; Buttocks ; Dapsone ; Female ; Fluorescent Antibody Technique, Direct ; Fluorescent Antibody Technique, Indirect ; Humans ; Immunoglobulin A ; Linear IgA Bullous Dermatosis* ; Middle Aged ; Mouth Mucosa ; Skin ; Thigh ; Tongue

Due to the limited availability of immunoelectron microscopy, an alternative method for the differentiation between anti-lamina lucida and anti-sublamina densa antibodies was introduced; indirect immunofluorescence using NaCl-treated human skin as the substrate. In this study author examined sera and lesional skin of 4 cases of bullous pemphigoid (BP), and 2 cases of epidermolysis bulloaa acquisita(EBA) with the above mentioned indirect imrnunofluorescence and modified direct immunofluorescence to evaluate the specificity of the tests. The results showed that in BP the fluorescence patterns were epidermal in 3 patients with 1 combined by indirect immunofluorescence, and epidermal in all 4 patients by modified direct immunofluorescence. In ERA the fluorescence were dermal patterns in both 2 patients by indirect and modified direct immunofluorescence. These data are further confirming the syecificity and the reproducibility of the NaCl extraction technique for the irnmunofluorescence to differentiate the localization of the autoantibodies in the above two bullous dermatoses.
Antibodies ; Autoantibodies ; Epidermolysis Bullosa Acquisita* ; Epidermolysis Bullosa* ; Fluorescence ; Fluorescent Antibody Technique ; Fluorescent Antibody Technique, Direct ; Fluorescent Antibody Technique, Indirect ; Humans ; Microscopy, Immunoelectron ; Pemphigoid, Bullous* ; Sensitivity and Specificity ; Skin ; Skin Diseases, Vesiculobullous

No abstract available.
Chlamydia* ; Fluorescent Antibody Technique, Indirect*

We report a rare case of bullous scabies with bullous pemphigoid in a 59-year-old male patient. He presented with a 9-month history of exhibiting multiple, variable-sized, red-to-brown, pruritic cutaneous patches, and papules with tense bullae on his whole body. A direct smear of the bullous lesions was performed and was negative for scabies mites. Histopathologic findings (hematoxylin and eosin staining) revealed Sarcoptes scabiei in the stratum corneum. There were sub-epidermal blisters with massive eosinophil and lymphocyte infiltration in the epidermis and upper dermis. Direct immunofluorescence microscopy showed linear deposition of IgG at the dermo-epidermal junction. Indirect immunofluorescence microscopy of samples acquired for the salt-split skin test showed linear IgG deposition in the epidermis. Skin lesions improved after the patient was treated with an anti-scabietic and steroids.
Blister ; Dermis ; Eosine Yellowish-(YS) ; Eosinophils ; Epidermis ; Fluorescent Antibody Technique, Direct ; Fluorescent Antibody Technique, Indirect ; Humans ; Immunoglobulin G ; Lymphocytes ; Male ; Microscopy ; Middle Aged ; Mites ; Pemphigoid, Bullous* ; Sarcoptes scabiei ; Scabies* ; Skin ; Skin Tests ; Steroids ; Transcutaneous Electric Nerve Stimulation

Anti-p200 pemphigoid is an autoimmune subepidermal bullous disease characterized by circulating and tissue-bound autoantibodies directed against a 200 kD protein of the human dermis. We report a 78-year-old male who was presented with bullous eruptions on the trunk, extremities, which clinically resemble bullous pemphigoid, epidermolysis bullosa aquisita, linear IgA dermatosis or dermatitis herpetiformis. Oral muscosa of the lower lip was also affected. Histopathological examination of a skin biopsy specimen from the trunk revealed subepidermal blister and infiltration predominantly by neutrophils. Direct immunofluorescence revealed linear deposits of IgG, C3 and IgA at the basement membrane zone. Indirect immunofluorescence using salt-split skin showed that IgG antibodies bound on the dermal side. Immunoblotting with dermal extracts showed that the patient's IgG autoantibodies reacted with a 200 kD protein. The patient showed good response to dapsone.
Aged ; Antibodies ; Autoantibodies ; Basement Membrane ; Biopsy ; Blister ; Dapsone ; Dermatitis Herpetiformis ; Dermis ; Epidermolysis Bullosa ; Extremities ; Fluorescent Antibody Technique, Direct ; Fluorescent Antibody Technique, Indirect ; Humans ; Immunoblotting ; Immunoglobulin A ; Immunoglobulin G ; Linear IgA Bullous Dermatosis ; Lip ; Male ; Neutrophils ; Pemphigoid, Bullous ; Skin

Anti-p200 pemphigoid is an autoimmune subepidermal bullous disease characterized by circulating and tissue-bound autoantibodies directed against a 200 kD protein of the human dermis. We report a 78-year-old male who was presented with bullous eruptions on the trunk, extremities, which clinically resemble bullous pemphigoid, epidermolysis bullosa aquisita, linear IgA dermatosis or dermatitis herpetiformis. Oral muscosa of the lower lip was also affected. Histopathological examination of a skin biopsy specimen from the trunk revealed subepidermal blister and infiltration predominantly by neutrophils. Direct immunofluorescence revealed linear deposits of IgG, C3 and IgA at the basement membrane zone. Indirect immunofluorescence using salt-split skin showed that IgG antibodies bound on the dermal side. Immunoblotting with dermal extracts showed that the patient's IgG autoantibodies reacted with a 200 kD protein. The patient showed good response to dapsone.
Aged ; Antibodies ; Autoantibodies ; Basement Membrane ; Biopsy ; Blister ; Dapsone ; Dermatitis Herpetiformis ; Dermis ; Epidermolysis Bullosa ; Extremities ; Fluorescent Antibody Technique, Direct ; Fluorescent Antibody Technique, Indirect ; Humans ; Immunoblotting ; Immunoglobulin A ; Immunoglobulin G ; Linear IgA Bullous Dermatosis ; Lip ; Male ; Neutrophils ; Pemphigoid, Bullous ; Skin

Linear IgA bullous dermatoses(LABD) occurring in childhood is considered to be a childhood counterpart of LABD,rather than chronic bullous dermatosis of childhood. This disease characteristically involves the perioral area,lower trunk,pelvic region and the lower extremities. Immunopathologically,it is characterized by the linear deposits of IgA at the dermoepidermal junction of the perilesional skin. A 20-month-old female infant presented with multiple pruritic tense bullae on the face, lower trunk, both extremities and pelvic region of 2 weeks duration. She had no oral lesions or any specific signs or symptoms referable to the disease of the gastrointestinal tract. A skin biopsy revealed subepidermal blisters infiltrated with many neutrophils and a few eosinophils. Direct immunofluorescence demonstrated linear deposition of IgA at the dermoepidermal junction. An indirect immunofluorescence study using NaC1-split skin as the substrate revealed fluorescence for IgA in a linear pattern on the roof of the split at a titer of 1:40. The clinical diagnosis of LABD of childhood was confirmed and we started with a combined remedy of dapsone and corticosteroids; 10 weeks later almost all of the lesions had disappeared.
Adrenal Cortex Hormones ; Biopsy ; Blister ; Dapsone ; Diagnosis ; Eosinophils ; Extremities ; Female ; Fluorescence ; Fluorescent Antibody Technique, Direct ; Fluorescent Antibody Technique, Indirect ; Gastrointestinal Tract ; Humans ; Immunoglobulin A ; Infant ; Linear IgA Bullous Dermatosis* ; Lower Extremity ; Neutrophils ; Pelvis ; Skin ; Skin Diseases ; Transcutaneous Electric Nerve Stimulation

No abstract available.
Diagnosis* ; Fluorescent Antibody Technique, Indirect* ; Herpes Simplex* ; Simplexvirus*