title: Possible enhancement of BP180 autoantibody production by herpes zoster.
abstract: Bullous pemphigoid (BP) is an autoimmune blistering disease caused by autoantibodies against type XVII collagen/BP180 (BP180). Although the mechanisms of autoantibody production remain to be elucidated, herpes virus infections have been identified as a possible triggering factor for pemphigus. We report a case of herpes zoster (HZ) having anti-BP180 serum antibodies. The patient developed sudden-onset, tense blisters and edematous erythema on the right anterior chest, shoulder and upper back. Histopathology showed remarkable degeneration of keratinocytes, acantholysis and blister formation with ballooning cells, indicating herpes virus infection. A polymerase chain reaction analysis of varicella zoster virus (VZV) was positive in crusts and effusions from the skin lesions, confirming the definitive diagnosis of HZ. Notably, we found that the patient had anti-BP180 serum antibodies in association with the occurrence of HZ. After successful treatment with valacyclovir hydrochloride for 7 days, the serum levels of anti-BP180 antibodies decreased in accordance with the improvement of skin lesions. These findings suggest that the production of anti-BP180 antibodies could be triggered by the reactivation of VZV.
authors.affiliation: Department of Dermatology, Toyokawa City Hospital, Toyokawa, Japan.|Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Kamiya
authors.affiliation: Department of Dermatology, Kawasaki Hospital, Kawasaki Medical School, Okayama, Japan.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Aoyama
authors.affiliation: Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: Department of General Medicine, Toei Hospital, Kitashitara-gun, Japan.
authors.forename: Haruo
authors.initials: H
authors.lastname: Niwa
authors.affiliation: Department of Dermatology, Toyokawa City Hospital, Toyokawa, Japan.
authors.forename: Ai
authors.initials: A
authors.lastname: Horio
authors.affiliation: Department of Dermatology, Toyokawa City Hospital, Toyokawa, Japan.
authors.forename: Eiichi
authors.initials: E
authors.lastname: Nishio
authors.affiliation: Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Tokura
mesh_terms: D000369:Aged, 80 and over; D001323:Autoantibodies / Q000096:biosynthesis* / Q000097:blood; D001324:Autoantigens / Q000276:immunology*; D005260:Female; D006562:Herpes Zoster / Q000150:complications / Q000276:immunology* / Q000473:pathology; D014645:Herpesvirus 3, Human / Q000472:pathogenicity; D006801:Humans; D024041:Non-Fibrillar Collagens / Q000276:immunology*; D010391:Pemphigoid, Bullous / Q000209:etiology / Q000276:immunology / Q000473:pathology; D000097805:Collagen Type XVII
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D024041:Non-Fibrillar Collagens; D000097805:Collagen Type XVII
keywords: BP180 antibody; autoantibody; bullous pemphigoid; herpes zoster; varicella zoster virus