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Article
March 1986

Linear IgA Bullous Dermatosis Clinically Simulating Pemphigus Vulgaris

Author Affiliations

Department of Pathology; Department of Dermatology Presbyterian Hospital Albuquerque, NM 87102; Department of Dermatology Tohoku University School of Medicine Sendai, Japan

Arch Dermatol. 1986;122(3):246-248. doi:10.1001/archderm.1986.01660150022006
Abstract

To the Editor.—  Dermatitis herpetiformis (DH), a pruritic chronic vesicular dermatosis, is characterized immunohistologically by granular or fibrillar IgA deposits at the dermal papillae of uninvolved and perilesional skin and in the jejunal mucosa that show the features of gluten-sensitive enteropathy. Immunogenetic data revealed increased prevalence of HLA-B8 and HLA-Dw3 in patients in whom DH develops.1,2 A gluten-free diet and dapsone therapy improve the symptoms of DH.There are a small group of patients with a DH-like eruption who show linear IgA deposition along the basement membrane zone (BMZ). Histologically, microabscesses, which are observed in DH at the tip of the dermal papilla, are not prominent. Based on the clinical picture, the microabscesses can be classified into two subgroups as follows: one group is characterized by small vesicles as in DH, and the other resembles bullous pemphigoid.3-6 In Japan, most cases, although having been diagnosed as DH clinically

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