title: A case of unique subepidermal blistering disease with autoantibodies against a novel dermal 200-kD antigen.
abstract: BACKGROUND
  Several autoimmune subepidermal blistering diseases with autoantibodies against the epidermal basement membrane zone (BMZ) have been identified. Each shows distinct immunological findings.
  
  
  OBJECTIVE
  Our patient showed clinical features which were indicative of bullous pemphigoid or linear IgA bullous dermatosis. In his serum, circulating IgG antibodies binding to the dermal side of skin split with 1 M NaCl were detected. To clarify the immunological character of the patient, we performed further studies.
  
  
  METHODS
  Western immunoblot analysis using normal human skin extracts and indirect immunofluorescence (IF) with affinity-purified IgG antibodies to the detected dermal protein were done.
  
  
  RESULTS
  Western immunoblot analysis demonstrated IgG antibodies reacting with a dermal 200-kD protein. Affinity-purified IgG antibodies to the 200-kD protein reacted to the dermal side of the split by indirect IF. Therefore, this dermal 200-kD protein is believed to be the epidermal BMZ antigen.
  
  
  CONCLUSIONS
  Our patient showed an immunologically unique subepidermal blistering disease.
authors.affiliation: Department of Dermatology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kawahara
authors.forename: Y
authors.initials: Y
authors.lastname: Matsuo
authors.forename: T
authors.initials: T
authors.lastname: Hashimoto
authors.forename: T
authors.initials: T
authors.lastname: Nishikawa
mesh_terms: D000368:Aged; D000941:Antigens / Q000032:analysis / Q000276:immunology*; D001323:Autoantibodies / Q000276:immunology*; D001485:Basement Membrane / Q000737:chemistry / Q000276:immunology; D015153:Blotting, Western; D003937:Diagnosis, Differential; D004817:Epidermis / Q000737:chemistry / Q000276:immunology*; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology; D007074:Immunoglobulin G / Q000276:immunology; D008297:Male; D010391:Pemphigoid, Bullous / Q000276:immunology* / Q000473:pathology; D012872:Skin Diseases, Vesiculobullous / Q000276:immunology* / Q000473:pathology
chemical_list: D000941:Antigens; D001323:Autoantibodies; D007070:Immunoglobulin A; D007074:Immunoglobulin G