Abstract | BACKGROUND: Anti-p200 pemphigoid is a recently described autoimmune subepidermal bullous dermatosis characterized by its target antigen and the associated anatomoclinical picture. The treatment is not as yet well defined. PATIENT AND METHODS: A 73-year-old man consulted for a pruritic bullous eruption with buccal involvement. Direct immunofluorescence revealed linear deposits of IgG and C3 at the dermal-epidermal junction. Elisa screening for circulating anti-BP180 and anti-BP230 antibodies was negative. A diagnosis of bullous pemphigoid was suspected. After an unfavourable clinical outcome under clobetasol and then prednisolone and methotrexate, other immunological tests were performed. Indirect immunofluorescence on NaCl-cleaved skin revealed a deposit of IgG4 antibodies on the dermal side. Immunoblotting showed antibodies directed against a 200-kDa antigen on a dermal extract. A diagnosis of anti-p200 pemphigoid was made. The patient was treated with dapsone combined with prednisolone. Seventy-two hours later, treatment was stopped due to hepatic cytolysis related to immunoallergic hepatitis. Treatment with mycophenolate mofetil was then initiated and resulted in complete remission, which persisted at seven months. DISCUSSION: CONCLUSION:
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Authors | D Raffin, M Delaplace, A Roussel, E Estève |
Journal | Annales de dermatologie et de venereologie
(Ann Dermatol Venereol)
Vol. 140
Issue 12
Pg. 784-7
(Dec 2013)
ISSN: 0151-9638 [Print] France |
Vernacular Title | Pemphigoïde anti-p200: rémission sous mycophénolate mofétil (Cellcept®). |
PMID | 24315224
(Publication Type: Case Reports, Journal Article)
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Copyright | Copyright © 2013. Published by Elsevier Masson SAS. |
Chemical References |
- Autoantibodies
- Autoantigens
- Immunoglobulin G
- Immunosuppressive Agents
- Laminin
- laminin gamma 1
- Dapsone
- Prednisolone
- Clobetasol
- Mycophenolic Acid
- Methotrexate
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Topics |
- Aged
- Autoantibodies
(analysis, immunology)
- Autoantigens
(immunology)
- Clobetasol
(therapeutic use)
- Dapsone
(therapeutic use)
- Drug Resistance
- Humans
- Immunoglobulin G
(analysis, immunology)
- Immunosuppressive Agents
(therapeutic use)
- Laminin
(immunology)
- Male
- Methotrexate
(therapeutic use)
- Mycophenolic Acid
(analogs & derivatives, therapeutic use)
- Pemphigoid, Benign Mucous Membrane
(drug therapy, immunology)
- Pemphigoid, Bullous
(drug therapy, immunology)
- Prednisolone
(therapeutic use)
- Remission Induction
- Skin
(immunology)
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