2019 Volume 18 Issue 6 Pages 344-348
A 59-year-old woman presented with blisters and erythema on her neck and both palms, which had persisted for 7 months. Physical examination revealed multiple tense blisters and erosions on the trunk, extremities, and buccal mucosa. Histopathological examination demonstrated subepidermal bullae and lymphocytic inltration in the upper dermis. Immunostaining for type IV collagen was positive on the dermal side. Direct immunouorescence of the lesional skin revealed the linear deposition of IgG and C3 at the basement membrane zone. Indirect immunouorescence examination of 1 M NaCl-split normal human skin demonstrated IgG reactivity with the dermal side of the cleft. Enzyme-linked immunosorbent assay detected IgG autoantibodies against type VII collagen. The patient was diagnosed with epidermolysis bullosa acquisita based on the clinical,pathological, and immunological ndings. The skin lesions were well-controlled by prednisolone at 15 mg (0.3 mg/kg)/day. Type IV collagen positivity on the dermal side suggested separation at the lamina lucida due to inammation. Skin Research, 18 : 344-348, 2019
