Successful treatment of oral linear IgA disease using mycophenolate.
Linear IgA disease (LAD) is a rare acquired autoimmune bullous disorder, characterized by linear deposition of IgA along the dermoepidermal basement membrane zone. The clinical presentation of LAD consists of vesiculobullous lesions affecting the skin and mucosal surfaces. The present case report presents a rare presentation of this vesiculobullous disorder. Although more than 50% of LAD patients present with oral lesions, there are few reported cases of involvement of the mouth as the sole manifestation. A 79-year-old female presented with a sore mouth and erosions affecting the palate. The symptoms resolved following the provision of mycophenolate, an antiproliferative immunosuppressant which has not previously appeared to have been reported in the long-term successful management of linear IgA disease limited to the mouth. We found that mycophenolate is a useful adjunct to the successful treatment of oral linear IgA when the uses of other immunosuppressants are contraindicated.
Lewis
M A O
MA
Department of Oral Surgery, Medicine and Pathology, Cardiff University School of Dentistry, Cardiff, Wales. lewismao@cardiff.ac.uk
Yaqoob
N A
NA
Emanuel
C
C
Potts
A J C
AJ
D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001379:Azathioprine / Q000009:adverse effects; D003937:Diagnosis, Differential; D005260:Female; D005455:Fluorescent Antibody Technique; D019085:Fluorescent Antibody Technique, Direct; D005882:Gingival Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019226:Oral Ulcer / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D011239:Prednisolone / Q000627:therapeutic use; D012872:Skin Diseases, Vesiculobullous / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology
D000893:Anti-Inflammatory Agents; D007070:Immunoglobulin A; D007166:Immunosuppressive Agents; D011239:Prednisolone; D009173:Mycophenolic Acid; D001379:Azathioprine