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January 1991

A Peculiar Case of Linear IgA Bullous Dermatosis

Author Affiliations

Clinica Dermatologica I; Clinica Dermatologica II University of Florence Via Della Pergola 58 1-50121 Florence, Italy; Clinica Dermatologica University of Sassari I-07100 Sassari, Italy

Arch Dermatol. 1991;127(1):126-127. doi:10.1001/archderm.1991.01680010138031

To the Editor.—  We observed an adult patient with sequential development of mucosal lesions typical of cicatricial pemphigoid (CP) and skin lesions clinically suggestive of early, urticarioid bullous pemphigoid (BP). Direct immunofluorescence showed a linear IgA deposition at the dermoepidermal junction in both lesions. The patient did not respond either to the classic combined treatment with diamino-dimethyl-sulfone (DDS) and steroids or to immunosuppressive agents. Interestingly, on the contrary, the mucosal and cutaneous lesions showed a specifically different response to different treatments, ie, the lesions were satisfactorily cured by low doses of tetracyclines and oral steroids, respectively. A 61-year-old man was first seen in 1986 with erythematous and erosive lesions of the conjunctival, oral (Fig 1), prepucial, and epiglottal mucosa for 8 months. Major symptoms consisted of burning and clear reduction of smell and taste sensitivity. Histologic examination, performed on a prepucial biopsy specimen, showed a subepithelial bulla and a perivascular

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