In 41% of patients (15 of 37), a shift occurred in anti-dsg antibody profile over time. The changes varied (Table). Of the 21 patients initially testing positive for both antibodies, 9 had no change in profile, 6 ultimately showed anti-dsg1–negative results, 3 ultimately showed anti-dsg3–negative results, and 3 ultimately tested negative for both antibodies. In 15 patients initially testing positive for anti-dsg3 and negative for anti-dsg1 antibodies, 13 had no change in profile, and 2 ultimately showed anti-dsg1–positive results. No patients showed anti-dsg3–negative results. One patient had only anti-dsg1 antibodies at baseline and tested positive for both antibodies at the final measurement. The reason for these changes was not determined, but possibilities include antigenic drift and changes in the course of the disease (eg, relapse vs continuous disease activity).