A Case of Pemphigus Foliaceus Coexisted with Bullous Pemphigoid

DOI
  • Ikeda Aya
    Department of Dermatology, National Hospital Organization Osaka National Hospital
  • Fujimori Nagisa
    Department of Dermatology, National Hospital Organization Osaka National Hospital
  • Kobayashi Yuka
    Department of Dermatology, National Hospital Organization Osaka National Hospital
  • Kaganoi Akari
    Department of Dermatology, National Hospital Organization Osaka National Hospital
  • Ozawa Kentaro
    Department of Dermatology, National Hospital Organization Osaka National Hospital

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Other Title
  • 落葉状天疱瘡に水疱性類天疱瘡を合併した 1 例

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Abstract

<p>A 69-year-old woman presented with itchy blisters and erythema on her trunk and upper limbs that developed 6 months ago. Skin biopsy revealed an intraepidermal blister with acantholytic cells in the cavity. Direct immunofluorescence demonstrated intercellular deposits of IgG and C3 in the epidermis, and anti-Desmoglein1 antibodies were detected by enzyme-linked immunosorbent assay (ELISA), resulting in the diagnosis of pemphigus foliaceus. Although her skin condition improved by tetracycline, niacinamide, diaminodiphenylsulfone and topical steroid treatment, her rash temporarily recurred 7 years later in association with an increase in anti-Desmoglein1 antibody. Four months later, itchy tense bullas developed on her limbs. Skin biopsy revealed subepidermal bulla containing eosinophils. Direct immunofluorescence detected depositions of IgG and C3 along the basement membrane zone and in the intercellular space of the epidermis, and anti-BP180 antibody was positive on ELISA, resulting in the diagnosis of pemphigus foliaceus accompanied by bullous pemphigoid. She was treated using oral prednisolone. The onset of bullous pemphigoid in our case may have been related to pemphigus foliaceus. When skin lesions different from the original diagnosis develop during the clinical course of autoimmune blistering disease, further investigation for a new blistering disease is required. Skin Research, 20 : 97-103, 2021 </p>

Journal

  • Hifu no kagaku

    Hifu no kagaku 20 (2), 97-103, 2021

    Meeting of Osaka Dermatological Association/Meeting of Keiji Dermatological Association

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