Herein, we report a case of paraneoplastic pemphigus with mild skin features of pemphigus foliaceus and lichenoid stomatitis associated with B-cell lymphoma. A 49-year-old man presented with scattered blisters and erosions on the trunk along with mucosal blisters and erosions. Skin biopsy showed subcorneal acantholytic bulla and oral mucosal biopsy demonstrated lichenoid dermatitis. Direct immunofluorescence showed cell surface deposits of IgG and C3. Indirect immunofluorescence identified circulating IgG autoantibodies to the cell surfaces of normal human skin and also on the transitional epithelium of rat bladder. Enzyme-linked immunosorbent assay using recombinant baculoproteins showed positive antidesmoglein 1 autoantibodies (index 46) but negative antidesmoglein 3 autoantibodies (index 8). Immunoblot analysis using normal human epidermal extract detected BP230 and the 190 kDa periplakin, while immunoprecipitation using radiolabeled cultured keratinocyte immunoprecipitated BP230 and the 210 kDa envoplakin. We consider that the skin lesion was produced by humoral immunity whereas the oral lesion was produced by cellular immunity.
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| http://dx.doi.org/10.1155/2010/931340 | DOI Listing |
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Article Synopsis
- Autoimmune blistering disorders (AIBD) are conditions where the body produces auto-antibodies against adhesion proteins in the skin, detectable through direct immunofluorescence (DIF) or blood tests like ELISA.
- This study aimed to assess how well the results from a new multivariant ELISA method agreed with AIBD diagnoses established from clinical assessments, histopathology, and DIF.
- The results showed a good overall correlation between ELISA and diagnoses, particularly strong in pemphigus vulgaris, but with variable agreement levels in other types of AIBD and limitations due to the retrospective nature of the study.
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