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To the Editor.—
We have recently studied the case of a patient who had bullous systemic lupus erythematosus similar to that reported by Pedro and Dahl in the Archives (107:118, 1973), where direct immunofluorescent studies made the early diagnosis when other tests were not helpful.A 55-year-old white woman was examined at the University of California, Los Angeles Medical Center in November 1972. She had a generalized vesiculobullous eruption since May 1972. Results of a test for antinuclear antibodies (ANA), done by another hospital, were negative. The clinical diagnosis was erythema multiforme and her histological diagnosis was bullous pemphigoid. With this discrepancy, immunofluorescent studies were performed, but not until December 1972. Direct immunofluorescent staining of a bullous lesion and uninvolved skin demonstrated a bright dense granular band of IgG, IgM, β1C (complement), and fibrinogen, but no IgA, at the dermoepidermal junction; in contrast, Pedro and Dahl found IgA, but
Krain LS, Rosenthal LH. Bullous Systemic Lupus Erythematosus in a Patient. Arch Dermatol. 1973;107(6):916. doi:10.1001/archderm.1973.01620210076021