title: Lichen planus pemphigoides is a heterogeneous disease: a report of five cases studied by immunoelectron microscopy.
abstract: Lichen planus pemphigoides (LPP) is a rare and controversial disease. It is characterized by bullae arising on lichen planus papules and on uninvolved skin, subepidermal bullae in histology, and linear deposits of IgG and C3 along the basal membrane zone on immunofluorescence of peribullous skin. Our goal was to identify the localization of the target antigen in cases of LPP. Five patients diagnosed with LPP on clinical, histological and immunofluorescence criteria were explored by immunoelectron microscopy and immunoblot. Our results show that the target antigen in LPP is not unique. The localization of the immune deposits was consistent with a diagnosis of bullous pemphigoid in two cases, of cicatricial pemphigoid in two cases and of epidermolysis bullosa acquisita in one case. Our study supports the view that LPP is a heterogeneous condition in which lichen planus may induce different subepidermal acquired bullous dermatoses.
authors.affiliation: Department of Dermatology, Hôpital Saint Louis, Paris, France. bouloc@univ-paris12.fr
authors.forename: A
authors.initials: A
authors.lastname: Bouloc
authors.forename: M D
authors.initials: MD
authors.lastname: Vignon-Pennamen
authors.forename: F
authors.initials: F
authors.lastname: Caux
authors.forename: D
authors.initials: D
authors.lastname: Teillac
authors.forename: J
authors.initials: J
authors.lastname: Wechsler
authors.forename: M
authors.initials: M
authors.lastname: Heller
authors.forename: C
authors.initials: C
authors.lastname: Lebbé
authors.forename: B
authors.initials: B
authors.lastname: Flageul
authors.forename: P
authors.initials: P
authors.lastname: Morel
authors.forename: L
authors.initials: L
authors.lastname: Dubertret
authors.forename: C
authors.initials: C
authors.lastname: Prost
mesh_terms: D000293:Adolescent; D000328:Adult; D015153:Blotting, Western; D002648:Child; D003176:Complement C3 / Q000032:analysis; D004820:Epidermolysis Bullosa / Q000276:immunology; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D008010:Lichen Planus / Q000276:immunology / Q000473:pathology*; D008297:Male; D016253:Microscopy, Immunoelectron; D010390:Pemphigoid, Benign Mucous Membrane / Q000276:immunology; D010391:Pemphigoid, Bullous / Q000276:immunology / Q000473:pathology*
chemical_list: D003176:Complement C3; D007074:Immunoglobulin G