A case of epidermolysis bullosa acquisita with autoantibody to anti-p200 pemphigoid antigen and exfoliative esophagitis.
BACKGROUND
Some cases of a subepidermal blistering disease associated with autoantibodies to more than two antigens have been reported.


METHODS
A 52-year-old Japanese woman had pruritic blisters on almost the whole body as well as erosive lesions in the oral cavity and esophagus. A histological finding was subepidermal bullae. Direct immunofluorescence (IF) revealed a linear deposition of IgG, IgM and C3 at the epidermal basement membrane zone (BMZ). Indirect IF using human skin split by 1 M NaCl as a substrate showed IgG antibody reactive with the dermal side. By immunoblot analysis using normal human dermal extract, the 200-kDa and 290-kDa bands were detected. Indirect IF did not show any anti-BMZ antibody activity, when using the skin of the patient with recessive dystrophic epidermolysis bullosa as a substrate.


CONCLUSIONS
We regarded our case as epidermolysis bullosa acquisita with autoantibody to anti-p200 pemphigoid antigen. This is the second case in the literature associated with autoantibodies to these two antigens.
Yamada
Tomoko
T
Department of Dermatology, Jichi Medical School, Tochigi, Japan. tomoko-y@jichi.ac.jp
Suzuki
Masayuki
M
Koike
Yumiko
Y
Kida
Kinuyo
K
Murata
Satoru
S
Ishii
Norito
N
Hashimoto
Takashi
T
Ohtsuki
Mamitaro
M
D001323:Autoantibodies / Q000276:immunology*; D001324:Autoantigens / Q000276:immunology*; D016107:Epidermolysis Bullosa Acquisita / Q000150:complications / Q000276:immunology*; D004941:Esophagitis / Q000209:etiology / Q000276:immunology*; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D015151:Immunoblotting; D008875:Middle Aged; D010391:Pemphigoid, Bullous / Q000276:immunology*
D001323:Autoantibodies; D001324:Autoantigens