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January 2002

Clinical and Serological Transition From Pemphigus Vulgaris to Pemphigus Foliaceus Demonstrated by Desmoglein ELISA System

Author Affiliations

From the Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

Arch Dermatol. 2002;138(1):95-96. doi:10.1001/archderm.138.1.95

Several cases in which the disease course has undergone a transition from pemphigus vulgaris (PV) to pemphigus foliaceus (PF) or vice versa have been reported in the literature. The disease transition in these cases was determined by means of clinical and histopathological observations and immunoblot analysis. To our knowledge, the case described herein represents the first report to clearly demonstrate the serological transition from mucous PV to mucocutaneous PV to PF using a desmoglein (Dsg) enzyme-linked immunosorbent assay (ELISA) system.

A 55-year-old Japanese man presented to our outpatient clinic in March 1997 with a 3-month history of intractable oral erosions (Figure 1A). Clinical, histopathological, and immunological findings led to the diagnosis of PV. Using a Dsg ELISA system (Dsg1/3 ELISA kit; Medical & Biological Laboratories Co Ltd, Nagona, Japan), only anti-Dsg3 autoantibodies (index, 214.07) were detectable (Figure 2A); the oral lesions had been well controlled with a dexamethasone gargle.