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We describe a 53-year-old man with a two-year history of bullous disease. He had also had stage IV gastric cancer for 3 years. He presented with cutaneous erythemas and blisters, showing an annular arrangement. Histopathological examination revealed intraepidermal pustules of eosinophils and neutrophils without apparent acantholysis. Indirect immunofluorescence (IIF) analysis showed IgG anti-keratinocyte cell surface antibodies. The result of IIF on rat bladder was positive. IgG enzyme-linked immunosorbent assays failed to detect antibodies to either anti-desmoglein-1 (Dsg1), Dsg3, or BP180. Immunoblot analysis with normal human epidermal extract revealed IgG reactivity with 120, 110, and 100 kDa species. Immunofluorescence analysis using COS-7 cells that expressed desmocollin (Dsc) 1, 2, and 3 demonstrated that IgG autoantibodies in the patient's serum reacted with all Dsc1-3. A heterogeneous autoantibody profile including IgG reactivity against Dsc1-3 implicated association with cancer-related pemphigoid, although the findings did not fulfill the diagnostic criteria of paraneoplastic pemphigus. A review of the literature revealed that rare autoantibodies to Dsc, most of which were IgA class, were detected in 7 reported bullous diseases. In 5 out of 7 cases, they were combined with autoantibodies to bullous pemphigoid or pemphigus vulgaris. This is the first case that has IgG autoantibodies to all Dsc1~3.
ejd.2011.1473 Auteur(s) : Yuichiro Endo1 yendou-tky@umin.ac.jp, Tomoyuki Shirase2, Atsushi Utani3, Yoshiaki Yoshikawa1 1 Department of Dermatology 2 Department of Pathology, Otsu Red Cross Hospital, 1-1-35 Nagara Otsu-shi, Shiga 520-8511, Japan 3 Department of Dermatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan Isolated collagenoma is one of the connective tissue nevi which present a hamartomatous overgrowth of otherwise normal collagen [1]. These lesions can [...]
Malignant melanoma is the malignancy with the highest rate of metastatic dissemination to the central nervous system (CNS) [1]. A combination of dabrafenib (a V600-mutated BRAF inhibitor) and trametinib (a MEK inhibitor [serving as an escape mechanism from BRAF inhibition]) (DT) therapy is expected to have an effect on brain metastasis, but the efficacy of DT therapy on brain metastasis is still under investigation since patients with brain metastases were excluded from a recent trial [2]. To date, [...]
