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Prurigo pigmentosa clinically and immunologically mimicking autoimmune bullous disease: A case report
A 15-year-old Japanese male noticed brown macules on his back 9 months ago. Initial examination revealed reticulated infiltrative erythema and pigmentation with blisters on the erythema of the back. Histopathology showed blisters with eosinophil infiltration in the epidermis, and direct immunofluore...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9755325/ https://www.ncbi.nlm.nih.gov/pubmed/36530916 http://dx.doi.org/10.3389/fmed.2022.1047870 |
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author | Kita, Kanako Kurokawa, Ichiro Hayashi, Daisuke Hashimoto, Takashi |
author_facet | Kita, Kanako Kurokawa, Ichiro Hayashi, Daisuke Hashimoto, Takashi |
author_sort | Kita, Kanako |
collection | PubMed |
description | A 15-year-old Japanese male noticed brown macules on his back 9 months ago. Initial examination revealed reticulated infiltrative erythema and pigmentation with blisters on the erythema of the back. Histopathology showed blisters with eosinophil infiltration in the epidermis, and direct immunofluorescence showed negative results for immunoglobulin (Ig) G, Ig A, Ig M, and C3 in the epidermal basement membrane zone. Immuno-serological tests revealed the presence of IgG antibodies against BP180, linear IgA disease antigen 1 (LAD-1), and laminin α3. The autoimmune bullous disease was suspected, and prednisolone at a concentration of 20 mg/day (0.3 mg/kg/day) was started. When the prednisolone dose was reduced to 10 mg/day, erythema and blisters recurred. The patient was diagnosed with prurigo pigmentosa based on clinical features and was treated successfully with oral doxycycline hydrochloride hydrate and topical tacrolimus ointment. This is the first case of prurigo pigmentosa with blisters in which autoantibodies to the epidermal basement membrane zone were found, which might be secondary non-pathogenic antibodies. |
format | Online Article Text |
id | pubmed-9755325 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-97553252022-12-17 Prurigo pigmentosa clinically and immunologically mimicking autoimmune bullous disease: A case report Kita, Kanako Kurokawa, Ichiro Hayashi, Daisuke Hashimoto, Takashi Front Med (Lausanne) Medicine A 15-year-old Japanese male noticed brown macules on his back 9 months ago. Initial examination revealed reticulated infiltrative erythema and pigmentation with blisters on the erythema of the back. Histopathology showed blisters with eosinophil infiltration in the epidermis, and direct immunofluorescence showed negative results for immunoglobulin (Ig) G, Ig A, Ig M, and C3 in the epidermal basement membrane zone. Immuno-serological tests revealed the presence of IgG antibodies against BP180, linear IgA disease antigen 1 (LAD-1), and laminin α3. The autoimmune bullous disease was suspected, and prednisolone at a concentration of 20 mg/day (0.3 mg/kg/day) was started. When the prednisolone dose was reduced to 10 mg/day, erythema and blisters recurred. The patient was diagnosed with prurigo pigmentosa based on clinical features and was treated successfully with oral doxycycline hydrochloride hydrate and topical tacrolimus ointment. This is the first case of prurigo pigmentosa with blisters in which autoantibodies to the epidermal basement membrane zone were found, which might be secondary non-pathogenic antibodies. Frontiers Media S.A. 2022-12-02 /pmc/articles/PMC9755325/ /pubmed/36530916 http://dx.doi.org/10.3389/fmed.2022.1047870 Text en Copyright © 2022 Kita, Kurokawa, Hayashi and Hashimoto. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Medicine Kita, Kanako Kurokawa, Ichiro Hayashi, Daisuke Hashimoto, Takashi Prurigo pigmentosa clinically and immunologically mimicking autoimmune bullous disease: A case report |
title | Prurigo pigmentosa clinically and immunologically mimicking autoimmune bullous disease: A case report |
title_full | Prurigo pigmentosa clinically and immunologically mimicking autoimmune bullous disease: A case report |
title_fullStr | Prurigo pigmentosa clinically and immunologically mimicking autoimmune bullous disease: A case report |
title_full_unstemmed | Prurigo pigmentosa clinically and immunologically mimicking autoimmune bullous disease: A case report |
title_short | Prurigo pigmentosa clinically and immunologically mimicking autoimmune bullous disease: A case report |
title_sort | prurigo pigmentosa clinically and immunologically mimicking autoimmune bullous disease: a case report |
topic | Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9755325/ https://www.ncbi.nlm.nih.gov/pubmed/36530916 http://dx.doi.org/10.3389/fmed.2022.1047870 |
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