We report a 66-year-old woman presenting with an annular erythematous and bullous eruption. Her clinical and histological findings were similar to those of linear IgA bullous dermatosis or dermatitis herpetiformis. Direct immunofluorescence revealed linear deposition of IgA, IgG and C3 along the basement membrane zone (BMZ). Indirect immunofluorescence detected IgG and IgA antibodies against the BMZ. Salt-split skin technique demonstrated that IgG antibodies bound exclusively to the dermal side, while IgA antibodies bound not only to the dermal side, but also to the epidermal side with relatively weak intensity. On immunoblot analysis, the patient's IgG antibodies exclusively reacted with a band of 200-kDa, while the antigenic target of IgA antibodies was not identified. The present case is thought to be a unique bullous dermatosis mediated by both the IgG antibodies to a novel 200-kDa antigen and IgA antibodies against undetermined antigens.

译文

:我们报告了一名66岁的女性,呈环形红斑和大疱性喷发。她的临床和组织学发现与线性IgA大疱性皮肤病或疱疹样皮炎相似。直接免疫荧光显示沿基底膜区(BMZ)线性沉积IgA,IgG和C3。间接免疫荧光检测到针对BMZ的IgG和IgA抗体。盐裂皮肤技术表明,IgG抗体仅与真皮侧结合,而IgA抗体不仅与真皮侧结合,而且还与强度相对较弱的表皮侧结合。在免疫印迹分析中,患者的IgG抗体仅与200 kDa的条带反应,而IgA抗体的抗原靶标未鉴定。本案被认为是由针对新型200 kDa抗原的IgG抗体和针对未确定抗原的IgA抗体介导的独特大疱性皮肤病。

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