A case of anti-p200 pemphigoid with autoantibodies against both a novel 200-kD dermal antigen and the 290-kD epidermolysis bullosa acquisita antigen.
BACKGROUND
Anti-p200 pemphigoid with autoantibodies against the 200-kD dermal antigen has recently been identified.


OBJECTIVE
Our patient showed small and tense blisters on her face and trunk.


METHODS
Immunoblotting (IB), using extracts of normal human epidermis and dermal skin, and immunoelectron microscopy (IEM), using normal human skin, were performed using the patient's serum.


RESULTS
IB analysis showed that the patient's serum did not react with 180-kD bullous pemphigoid (BP180) or BP230 antigens; however, IgG autoantibodies in the patient's serum reacted with a 200-kD dermal antigen as well as the 290-kD epidermolysis bullosa acquisita (EBA) antigen. IEM showed that IgG antibodies in the patient's serum bound to the lamina lucida, as well as both the lamina densa and sublamina densa. After the treatment with prednisolone, the 290-kD protein reactivity decreased rapidly; however, the 200-kD protein band was still observed.


CONCLUSIONS
We describe a rare case with immunoreactive autoantibodies against both a novel dermal 200-kD autoantigen and the 290-kD EBA antigen.
Department of Dermatology, Fukushima Medical University School of Medicine, Fukushima, Japan.
Hirotoshi
H
Furukawa
Takako
T
Miura
Masabumi
M
Takahashi
Koichiro
K
Nakamura
Fumio
F
Kaneko
Fumito
F
Ishii
Reiko
R
Komai
Takashi
T
Hashimoto
D000328:Adult; D001324:Autoantigens / Q000032:analysis*; D001707:Biopsy, Needle; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015151:Immunoblotting; D007150:Immunohistochemistry; D016253:Microscopy, Immunoelectron; D008911:Minocycline / Q000627:therapeutic use; D009525:Niacin / Q000627:therapeutic use; D010391:Pemphigoid, Bullous / Q000276:immunology* / Q000473:pathology*; D011239:Prednisolone / Q000627:therapeutic use; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
D001324:Autoantigens; C044589:epidermolysis bullosa acquisita antigen; D009525:Niacin; D011239:Prednisolone; D008911:Minocycline