Three cases of transition from pemphigus vulgaris to pemphigus foliaceus confirmed by desmoglein ELISA.
We report 3 cases of pemphigus vulgaris (PV) confirmed by histology and direct and indirect immunofluorescence that showed transition to pemphigus foliaceus (PF) 2-4 years from the time of disease onset. Desmoglein (Dsg) ELISA testing of the sera from these 3 patients in the later stages of their disease showed the presence of anti-Dsg1 antibodies and the absence of anti-Dsg3 antibodies. These patients were on prednisolone and immunosuppressives at the time the sera were tested, and it is unclear if the transition from PV to PF is a permanent one or whether it is due to preferential suppression of Dsg3 antibodies below a certain threshold. Previously reported cases of transition from PV to PF and PF to PV are summarized.
Ng
Patricia Pei Lin
PP
National Skin Centre, Singapore, Singapore. patriciang@nsc.gov.sg
Thng
Steven Tien Guan
ST
D000328:Adult; D001707:Biopsy, Needle; D003598:Cytoskeletal Proteins; D051183:Desmoglein 1; D051182:Desmogleins; D051180:Desmoplakins; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D019084:Fluorescent Antibody Technique, Indirect; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010392:Pemphigus / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
D003598:Cytoskeletal Proteins; C495297:DSG1 protein, human; D051183:Desmoglein 1; D051182:Desmogleins; D051180:Desmoplakins; D007166:Immunosuppressive Agents