A 68-year-old woman presented with the chief complaint of diffuse alopecia on the head. The patient had a past history of hypercortisolemia. She developed diffuse alopecia three months before the first presentation. She considered the changes to be due to aging and underwent treatment for increasing hair volume one month prior to her visit. However, the condition worsened, and she finally came to our hospital. At the first examination, she had diffuse alopecia, hair loss tendency, and black spots on her entire head. Periodic acid-Schiff staining showed fungus body component in the hair follicles. Tinea lesions were also noted on her entire body. Based on the results of fungal culture and DNA sequencing, the patient was diagnosed with diffuse tinea caused by Trichophyton rubrum. The present case was diagnoses as diffuse tinea pedis due to impaired cellular immunity associated with hypercortisolemia. Diffuse tinea should be included in the differential diagnosis because it may be associated with endocrine disease.
A 38-year-old man with a 10-year history of psoriasis vulgaris presented pruritic urticarial plaques and blisters on his entire body, but without any mucosal involvements. Direct immunofluorescence revealed linear deposits of immunoglobulin (Ig) G and C3 along the basement membrane zone (BMZ). Indirect immunofluorescence (IIF) demonstrated circulating IgG antibodies to BMZ of normal human skin. IIF using 1M NaCl-split skin revealed IgG antibodies reacting with the dermal side of the split skin revealing. IgG immunoblotting of recombinant laminin 332 reacted positively with the 165 kDa α3 subunit. We diagnosed this case as pemphigoid with autoantibodies to laminin 332 α3 subunit accompanied by psoriasis vulgaris and started oral administration of cyclosporine A. This is a rare case of anti-laminin 332 pemphigoid associated with psoriasis.