https://orcid.org/0000-0002-6429-1498
-
Views
-
Cite
Cite
Y. Yamaguchi, S. Shinkuma, N. Ishii, S. Takashima, K. Natsuga, H. Ujiie, H. Iwata, T. Nomura, Y. Fujita, A. Hamasaka, K. Hamasaka, T. Hashimoto, H. Shimizu, Appearance of antidesmocollin 1 autoantibodies leading to a vegetative lesion in a patient with pemphigus vulgaris, British Journal of Dermatology, Volume 178, Issue 1, 1 January 2018, Pages 294–295, https://doi.org/10.1111/bjd.15834
Close - Share Icon Share
Extract
Funding sources: none.
Conflicts of interest: none declared.
Dear Editor, Pemphigus describes a group of autoimmune bullous diseases, mainly classified into pemphigus vulgaris and pemphigus foliaceus.1 Pemphigus vulgaris is further subcategorized into a mucocutaneous type [with autoantibodies against desmoglein (Dsg)3 and Dsg1] and a mucosal type (with autoantibodies against Dsg3 but not Dsg1) based on autoantibody profile and clinical features. Pemphigus vegetans (PVeg), a rare variant of pemphigus vulgaris, is characterized by vegetating lesions. However, the mechanism behind the occurrence of these elevated lesions remains unclear.2 Recently, it was reported that antidesmocollin (Dsc)1 and Dsc3 autoantibodies were frequently detected and potentially pathogenic in PVeg.3 Here we report a case of pemphigus vulgaris in which a vegetative plaque, accompanied by the elevation of anti‐Dsc1 autoantibodies, occurred during treatment.
A 39‐year‐old man was referred to our hospital with blisters and erosions on the whole body and oral mucosal erosions without vegetative lesions. A biopsy specimen obtained from a vesicle on his abdomen showed intraepidermal bullae in suprabasal and prickle cell layers containing many acantholytic cells. The upper dermis had a mild inflammatory infiltration, mainly lymphocytes. Direct immunofluorescence (DIF) revealed deposition of IgG and complement component 3 (C3) in the epidermal intracellular space. Enzyme‐linked immunosorbent assays (ELISA) index values of anti‐Dsg1 and anti‐Dsg3 IgGs (MBL, Nagoya, Japan) were 104·5 (cut‐off value 20·0) and 429·3 (cut‐off value 20·0), respectively. ELISAs for Dsc1, Dsc2 and Dsc3, which were performed as described previously,3 were negative for Dsc1 [optical density (OD) 0·054; cut‐off value 0·200], Dsc2 (OD 0·027; cut‐off value 0·070) and Dsc3 (OD 0·029; cut‐off value 0·120). From these findings, we made the diagnosis of mucocutaneous‐type pemphigus vulgaris.
