A case of unique subepidermal blistering disease with autoantibodies against a novel dermal 200-kD antigen.
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.
Kawahara
Y
Y
Department of Dermatology, Keio University School of Medicine, Tokyo, Japan.
Matsuo
Y
Y
Hashimoto
T
T
Nishikawa
T
T
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
D000941:Antigens; D001323:Autoantibodies; D007070:Immunoglobulin A; D007074:Immunoglobulin G