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December 1992

The Significance of Linear IgM Deposits in the Basement Membrane Zone

Arch Dermatol. 1992;128(12):1653. doi:10.1001/archderm.1992.04530010089021

To the Editer.  —We read the article by Cobb and coworkers1 in the March 1992 issue of the Archives with interest. This article concerned a patient with Waldenström macroglobulinemia, a pruritic papular eruption, and IgM-K deposits in the epidermal basement membrane zone (BMZ). In 1988, we published an article concerning 25 patients with linear IgM deposits in the epidermal BMZ.2 These deposits were found in- diseased and in clinically healthy skin and tended to persist throughout the years. In 2771 biopsy specimens examined by means of routine immunofluorescence, the frequency of this feature was 0.9% (in comparison, the frequency of bullous pemphigoid was 1.2%; linear IgA dermatosis, 0.01%). We could find no common denominator when reviewing the patients' serologic data and clinical picture. The range of clinical symptoms was as follows: pruritus/urticaria, nine cases; purpura, five cases; vesicles/bullae, four cases; nonspecific rash, three cases; and ulcers, two cases.