Coexistence of pemphigus herpetiformis with IgG antibodies to desmocollin 1 and pemphigoid with IgG antibodies to BP180 C-terminal domain and laminin γ2

摘要

Pemphigus herpetiformis (PH) cases with IgG antibodies to desmocollin 1 (Dsc1) and pemphigoid cases without mucosal involvement reactive with epitopes on various antigens of mucous membrane pemphigoid (MMP) are rare. We report a case of coexistence of these 2 bullous diseases.Report of a Case. A 63-year-old Japanese man with no relevant medical history developed pruritic small urticarial papules and erythemas with vesicles on the neck and upper extremities, which were exacerbated 1 month later. Physical examination revealed coalescing erythemas with peripheral vesicles on the trunk and extremities (Figure I A). Mucous membranes were not involved. Laboratory examination revealed hypereosinophilia (differential eosinophil count, 37.8%) with normal leukocyte count. Biopsy specimens from the right forearm revealed eosinophilic spongiosis together with intraepidermal bullae with eosinophils; specimens from the left forearm revealed subepidermal blister with eosinophils (Figure 1B-D).