Localized pretibial pemphigoid and pemphigoid nodularis.
We describe a 75-year-old woman with a chronic, blistering eruption on the left leg whose clinical and immunopathologic features were consistent with a diagnosis of localized pretibial pemphigoid. After a disease-free interval of 5 years she developed a generalized prurigo nodularis-like eruption. Immunofluorescence studies revealed deposition of IgG and C3 along the dermoepidermal junction, and circulating autoantibodies against the dermoepidermal junction were demonstrated. Indirect immunoelectron microscopic examination of saponin-treated skin samples showed deposits of immunoreactants over the intracellular part of the hemidesmosomes. By Western immunoblotting the 230 kd bullous pemphigoid antigen was recognized by circulating autoantibodies. Thus our patient had two unusual clinical variants of bullous pemphigoid: localized pretibial pemphigoid and pemphigoid nodularis.
Borradori
L
L
Clinique Dermatologique, Hôpital Saint-Louis, C.H.U. Saint Louis, Paris.
Prost
C
C
Wolkenstein
P
P
Bernard
P
P
Baccard
M
M
Morel
P
P
D000368:Aged; D001324:Autoantigens / Q000032:analysis; D002352:Carrier Proteins; D002908:Chronic Disease; D003094:Collagen; D003176:Complement C3 / Q000032:analysis; D003598:Cytoskeletal Proteins; D000071821:Dystonin; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007868:Leg Dermatoses / Q000276:immunology / Q000473:pathology*; D009419:Nerve Tissue Proteins; D024041:Non-Fibrillar Collagens; D010391:Pemphigoid, Bullous / Q000276:immunology / Q000473:pathology*; D012008:Recurrence; D012867:Skin / Q000276:immunology / Q000648:ultrastructure; D000097805:Collagen Type XVII
D001324:Autoantigens; D002352:Carrier Proteins; D003094:Collagen; D003176:Complement C3; D003598:Cytoskeletal Proteins; D000071821:Dystonin; D007074:Immunoglobulin G; D009419:Nerve Tissue Proteins; D024041:Non-Fibrillar Collagens; D000097805:Collagen Type XVII; C486268:DST protein, human