title: A Case of pemphigus foliaceus which occurred after five years of remission from pemphigus vulgaris.
abstract: A 77-year-old Japanese female developed pemphigus foliaceus (PF) after 5 years of remission from pemphigus vulgaris (PV). The patient had painful erosions in her mouth and flaccid blisters of the skin and was diagnosed as having PV, which responded well to corticosteroid treatment. She was then free from any lesion of PV for 5 years with a low dose of corticosteroid. Then she developed scaly erythematous lesions on the skin and was diagnosed as suffering from PF. Enzyme-linked immunosorbent assay (ELISA) using recombinant desmoglein 1 (Dsg-1) and Dsg-3 revealed that she had anti-Dsg-3 IgG in the PV stage, no antibodies during remission and anti-Dsg-1 IgG in the PF stage. These findings indicate that the target antigen was shifted from Dsg-3 to Dsg-1 along with the phenotype after a 5-year interval in this patient.
authors.affiliation: Department of Dermatology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kimoto
authors.forename: M
authors.initials: M
authors.lastname: Ohyama
authors.forename: Y
authors.initials: Y
authors.lastname: Hata
authors.forename: M
authors.initials: M
authors.lastname: Amagai
authors.forename: T
authors.initials: T
authors.lastname: Nishikawa
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D015820:Cadherins / Q000276:immunology; D051183:Desmoglein 1; D051184:Desmoglein 3; D005260:Female; D006801:Humans; D010392:Pemphigus / Q000188:drug therapy / Q000276:immunology / Q000473:pathology*; D012008:Recurrence; D012074:Remission Induction; D012867:Skin / Q000187:drug effects / Q000276:immunology / Q000473:pathology*; D013997:Time Factors
chemical_list: D000305:Adrenal Cortex Hormones; D015820:Cadherins; C071894:DSG3 protein, human; D051183:Desmoglein 1; D051184:Desmoglein 3