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Article
July 1982

Case for Diagnosis: Vesicular Pemphigoid?Immunofluorescence Microscopy Studies

Author Affiliations

From the Department of Dermatology, Henry Ford Hospital, Detroit. Dr Nims is in private practice in Vienna, Va.

Arch Dermatol. 1982;118(7):506-511. doi:10.1001/archderm.1982.01650190060021
Abstract

• A 47-year-old man was diagnosed as having dermatitis herpetiformis (DH) in 1957. His failure to respond to therapy and the advent of immunofluorescent techniques led to a subsequent tentative diagnosis of vesicular pemphigoid (VP). High-titered, antibasal zone antibodies were present. However, unlike previously reported cases, direct immunofluorescence microscopy initially showed a DH-like and, later, an atypical granular band instead of a tubular (linear) band but with bullous pemphigoid (BP)-like immunoglobulin composition. No IgA was present. The patient's serum antibasal zone antibodies reacted with his perilesional skin despite granular deposits present at the same site, suggesting concomitant BP- and DH-like immunologic phenomena. The non-IgA-containing atypical granular band might be an immunologic marker for a subset of VP or another distinct disease entity demonstrating an immunologic overlap between BP and DH.

(Arch Dermatol 1982;118:506-511)

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