title: Concomitant bullous pemphigoid and dermatitis herpetiformis.
abstract: Dermatitis herpetiformis and bullous pemphigoid are bullous autoimmune diseases of the skin microscopically characterized by subepidermal blisters. We present a 77-year-old patient with an 18-month history of disseminated pruritic papular lesions. Direct immunofluorescence microscopy revealed linear deposition of IgG at the basement membrane zone as well as granular deposits of IgA in the papillary dermis. Circulating IgG antibodies against BP180, BP230 and gliadin as well as IgA reactivity against endomysium, tissue transglutaminase, and gliadin were detected compatible with both bullous pemphigoid and dermatitis herpetiformis. Here, we review the English literature on all previously reported patients with co-occurrence of both entities. Interestingly, in previous cases, tissue-bound and serum autoantibodies against the respective target antigens had not yet been completely characterized.
authors.affiliation: Department of Dermatology, University of Lübeck, Lübeck, Germany.
authors.forename: Franziska
authors.initials: F
authors.lastname: Schulze
authors.forename: Nina
authors.initials: N
authors.lastname: van Beek
authors.forename: Patrick
authors.initials: P
authors.lastname: Terheyden
authors.forename: Detlef
authors.initials: D
authors.lastname: Zillikens
authors.forename: Enno
authors.initials: E
authors.lastname: Schmidt
mesh_terms: D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001323:Autoantibodies / Q000032:analysis / Q000097:blood*; D001324:Autoantigens / Q000276:immunology; D001485:Basement Membrane / Q000737:chemistry; D002352:Carrier Proteins; D002990:Clobetasol / Q000627:therapeutic use; D003598:Cytoskeletal Proteins; D003622:Dapsone / Q000627:therapeutic use; D003874:Dermatitis Herpetiformis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D020405:Dermis / Q000737:chemistry; D055050:Diet, Gluten-Free; D000071821:Dystonin; D019204:GTP-Binding Proteins; D005903:Gliadin / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis / Q000097:blood*; D007074:Immunoglobulin G / Q000032:analysis / Q000097:blood*; D008297:Male; D008562:Membrane Glycoproteins / Q000276:immunology; D009419:Nerve Tissue Proteins; D024041:Non-Fibrillar Collagens / Q000276:immunology; D010391:Pemphigoid, Bullous / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases / Q000276:immunology; D000097805:Collagen Type XVII
chemical_list: D000890:Anti-Infective Agents; D000893:Anti-Inflammatory Agents; D001323:Autoantibodies; D001324:Autoantigens; D002352:Carrier Proteins; D002990:Clobetasol; D003598:Cytoskeletal Proteins; D003622:Dapsone; D000071821:Dystonin; D019204:GTP-Binding Proteins; D005903:Gliadin; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D008562:Membrane Glycoproteins; D009419:Nerve Tissue Proteins; D024041:Non-Fibrillar Collagens; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D000097805:Collagen Type XVII; C486268:DST protein, human