Inflammatory variant of epidermolysis bullosa acquisita with IgG autoantibodies against type VII collagen and laminin α3

Marcel F. Jonkman, Jacqueline Schuur, Freark Dijk, Klaas Heeres, Marcelus C J M De Jong, Jan B. Van Der Meet, Kim B. Yancey, Hendri H. Pas

Research output: Contribution to journalArticlepeer-review

50 Scopus citations

Abstract

Background: The inflammatory variant of epidermolysis bullosa acquisita (EBA) may clinically closely resemble bullous or cicatricial pemphigoid. Patients with inflammatory EBA have IgG autoantibodies against type VII collagen. Patients with anti-epiligrin cicatricial pemphigoid have IgG autoantibodies against laminin 5. Observation: We describe a patient with inflammatory EBA exhibiting nonscarring oral and vaginal involvement. Indirect immunofluorescence using skin substrate lacking an epidermal basement membrane molecule, direct immunoelectron microscopy, immunoblot, and immunoprecipitation studies revealed the simultaneous presence of circulating IgG autoantibodies against type VII collagen and laminin α3. A final diagnosis of EBA was based on the sublamina densa level of blister formation. Conclusion: This case illustrates the clinical and immunological overlap between EBA and anti-epiligrin cicatricial pemphigoid, a unique finding that may have developed as a consequence of epitope spreading.

Original languageEnglish (US)
Pages (from-to)227-231
Number of pages5
JournalArchives of Dermatology
Volume136
Issue number2
DOIs
StatePublished - Feb 2000

ASJC Scopus subject areas

  • Dermatology

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