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Correspondence |

Coexistence of Pemphigus Herpetiformis With IgG Antibodies to Desmocollin 1 and Pemphigoid With IgG Antibodies to BP180 C-Terminal Domain and Laminin γ2

Chika Ohata, MD; Yuko Higashi, MD, PhD; Jun Yamagami, MD, PhD; Hiroshi Koga, MD; Norito Ishii, MD; Takuro Kanekura, MD, PhD; Minao Furumura, MD, PhD; Takashi Hashimoto, MD
JAMA Dermatol. 2013;149(4):502-504. doi:10.1001/jamadermatol.2013.1916.
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Pemphigus herpetiformis (PH) cases with IgG antibodies to desmocollin 1 (Dsc1) and pemphigoid cases without mucosal involvement reactive with epitopes on various antigens of mucous membrane pemphigoid (MMP) are rare.13 We report a case of coexistence of these 2 bullous diseases.

Correspondence: Dr Hashimoto, Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan (hashimot@med.kurume-u.ac.jp).

Conflict of Interest Disclosures: None reported.

Additional Contributions: We gratefully appreciate the secretarial work of Mss Hanako Tomita and Sachika Notomi. We thank the patient for his participation.

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Figure 1. Clinical image and hematoxylin-eosin–stained histopathologic specimens from the subject case. A, Skin lesions on the upper extremity. B and C, Biopsy specimen from the right forearm, showing eosinophilic spongiosis (B) (original magnification ×200) and intraepidermal bullae with eosinophils (C) (original magnification ×100). D, Biopsy specimen from the left forearm, showing subepidermal blister with eosinophils (original magnification ×40).

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Figure 2. Immunofluorescence and immunoblotting studies of the subject case. A-C, Direct immunofluorescence images for IgG (A), IgA (B), and C3 (C). D, Indirect immunofluorescence of rat bladder for IgG antibodies. E and F, Indirect immunofluorescence of 1M sodium chloride–split skin sections for IgG antibodies (E) and IgA antibodies (F). G, Immunoblotting of recombinant protein of BP180 C-terminal domain, showing positive reactivity by IgG antibodies in control anti-BP180 type mucous membrane pemphigoid (MMP) serum (lane 1) and patient IgG (lane 3) and IgA (weak) (lane 4) antibodies in this case. H, IgG immunoblotting of purified human laminin-332, showing strong reactivity with the α3, β3, and γ2 subunits of laminin-332 for control anti–laminin-332 type MMP (lane 1), and weak reactivity with only the γ2 subunit for this case (lane 3).




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