Lichen planus pemphigoides pdf

Our patient fulfilled the criteria for lichen planus pemphigoides, namely typical lichen planus clinically and pathologically in association with a bullous eruption on uninvolved skin. Furthermore, the bullae arose particularly on the extremities with pathological and immunological features of bullous pemphigoid, including in vivo bound and circulating anti-BMZ antibodies. There has, however, been uncertainty as to whether lichen planus pemphigoides should be regarded as an association between lichen planus and bullous pemphigoid or a separate disease entity.

Preliminary Western blotting results using our patient's serum similarity suggest that his circulating antibodies are not directed against the bullous pemphigoid antigen.

Our patient's immuno-electron microscopy results will be discussed. It seems likely that the circulating autoantibody in lichen planus pemphigoides is recognizing an antigen distinct from the bullous pemphigoid antigen. Coexisting lichen planus and bullous pemphigoid or lichen planus pemphigoides?

J Am Acad Dermatol ; 9; Lichen planus pemphigoides: an immuno-electron microscopic study. BrJ Dermatol ; Fragile skin has been noted since birth. The patient has suffered from recurrent dislocation of both thumbs, premature dental caries, leg ulceration and painful plantar callosities. An umbilical hernia was repaired in early childhood.

There is no positive family history. Related Papers. Lichen planus pemphigoides: its relationship to bullous pemphigoid. By Michele Murdoch. Lupus vulgaris complicated by metastatic squamous cell carcinoma. Autoimmune bullous diseases in childhood. By Vesna Petronic-rosic. Dermatology An Illustrated Colour Textbook. By Etiologi Osteoartritis. However, combinations of systemic with topical corticosteroids, potentially in combination with dapsone or acitretin are worth considering.

An improved understanding of the pathophysiology of LPP may help to shed new light on the mechanisms that lead to the development of autoantibodies against COL17 and subsequent blister formation.

AR identified the patient, performed literature search, and pharmacovigilance data analyses. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

We thank all people not mentioned here who were involved in patient care and routine laboratory diagnostics. We acknowledge financial support by Land Schleswig-Holstein within the funding programme Open Access Publikationsfonds. National Center for Biotechnology Information , U. Front Immunol. Published online Jul 2. Ewan A. Author information Article notes Copyright and License information Disclaimer. This article was submitted to Autoimmune and Autoinflammatory Disorders, a section of the journal Frontiers in Immunology.

Received Mar 26; Accepted Jun 3. The use, distribution or reproduction in other forums is permitted, provided the original author s and the copyright owner s are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. This article has been cited by other articles in PMC. Abstract Lichen planus pemphigoides LPP is a very rare autoimmune sub-epidermal blistering disease associated with lichenoid skin changes.

Definition Lichen planus pemphigoides can be best defined as an autoimmune dermatosis, the hallmarks of which are lichenoid and bullous skin lesions, which develop in the context of autoantibodies targeting type XVII collagen COL Epidemiology The exact prevalence of LPP is unknown. Clinical Features and Establishment of Diagnosis Diagnosis is based on careful correlation of the clinical, histopathological and immunopathological features.

Open in a separate window. Figure 1. Table 1 Drugs and conditions that were reported to be associated with LPP. Enalapril 64 7. Chinese herbs 65 n. Captopril 67 , 68 Varicella Chickenpox 72 , 73 n. Ramipril 74 Isoniazide d 75 n. Rifampin d 75 n. Ethambutol d 75 0. Hepatitis B Virus 77 , 78 n. Drugs associated with both lichen planus and pemphigoid are indicated by bold font face. LPP and Infections LPP has also been reported to be a complication of infection, particularly viral infections Table 1 , for example varicella 72 , 73 and hepatitis B 77 , LPP and Cancer An association of LPP with colon adenocarcinoma points raises the possibility of a paraneoplastic variant of the disease Comparison of Case Report Data With Pharmacovigilance Information Pharmacovigilance databases provide another valuable resource to identify drugs that may trigger the development of LPP.

The corresponding drug names and relationship parameter values are highlighted in red. Table 3 Reported treatment options for LPP since Individual cases may be counted multiple times with different drugs.

Treatment options with at least 10 reports are highlighted in bold font. Some publications report more than one case. Conclusion LPP is a very rare disease entity that belongs to a larger family of diseases characterized by autoantibodies against COL Conflict of Interest Statement The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgments We thank all people not mentioned here who were involved in patient care and routine laboratory diagnostics. References 1. Kaposi M. Lichen ruber pemphigoides. Arch Derm Syph. Stingl G, Holubar K. Coexistence of lichen planus and bullous pemphigoid. A immunopathological study. Br J Dermatol. Lichen planus pemphigoides: identification of kd hemidesmosome antigen. J Am Acad Dermatol.

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Lichen planus pemphigoides: four new cases and a review of the literature. Int J Dermatol. Liakopoulou A, Rallis E. Bullous lichen planus - a review.

J Dermatol Case Rep. T cells reactive with the NC16A domain of BP are present in vulval lichen sclerosus and lichen planus. J Eur Acad Dermatol Venereol. IgG antibodies to BP in a subset of oral lichen planus patients. J Dermatol Sci. Epithelial antigenic specificities of circulating autoantibodies in mucosal lichen planus. Autoreactivity to bullous pemphigoid is this the link between subepidermal blistering diseases and oral lichen planus? Cicatricial pemphigoid differs from bullous pemphigoid and pemphigoid gestationis regarding the fine specificity of autoantibodies to the BP NC16A domain.

Spectrum of autoimmune bullous diseases in Kuwait. Clinical, demographic and immunopathological spectrum of subepidermal autoimmune bullous diseases at a tertiary center: A 1-year audit. Indian J Dermatol Venereol Leprol.

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A 4-year retrospective study and review of the literature. Acta Dermatovenerol Croat. Incidence of autoimmune bullous diseases in Serbia: a year retrospective study: Incidence of autoimmune bullous diseases.

J Dtsch Dermatol Ges. IgG autoantibodies from a lichen planus pemphigoides patient recognize the NC16A domain of the bullous pemphigoid antigen Dermatol Basel Switz. A case of lichen planus pemphigoides with autoantibodies to the NC16a and C-terminal domains of BP and to desmoglein Narrowband UVB-induced lichen planus pemphigoide. Dermatol Rep. Lichen planus pemphigoides with circulating autoantibodies against and kDa epidermal antigens.

Eur J Dermatol. Bullous pemphigoid and herpes gestationis autoantibodies recognize a common non-collagenous site on the BP ectodomain. J Immunol. Cicatricial pemphigoid sera specifically react with the most C-terminal portion of BP Diagnosis of autoimmune blistering diseases. Front Med. Diagnosis of autoimmune bullous diseases. Bullous pemphigoid and linear IgA dermatosis sera recognize a similar kDa keratinocyte collagenous glycoprotein with antigenic cross-reactivity to BP IgA paraneoplastic pemphigus in angioimmunoblastic T-cell lymphoma with antibodies to desmocollin 1, type VII collagen and laminin Acta Derm Venereol.

Autoantibodies to bullous pemphigoid antigen induce dermal-epidermal separation in cryosections of human skin. Granulocyte-derived elastase and gelatinase B are required for dermal-epidermal separation induced by autoantibodies from patients with epidermolysis bullosa acquisita and bullous pemphigoid. J Pathol. Repetitive immunization breaks tolerance to type XVII collagen and leads to bullous pemphigoid in mice.

The role of complement in experimental bullous pemphigoid. J Clin Invest. The alternative pathway of complement activation is critical for blister induction in experimental epidermolysis bullosa acquisita. Iwata H, Ujiie H. Complement-independent blistering mechanisms in bullous pemphigoid. Exp Dermatol. Tissue destruction in bullous pemphigoid can be complement independent and may be mitigated by C5aR2.

Bullous pemphigoid suggestive of complement-independent blister formation with anti-BP IgG4 autoantibodies. Indirect identified by the reference serum. The single exception immunofluorescence was positive on at least one sub- bound to the kDa minor BP antigen. Two of the Table 5. A typing three LPP patients were positive on immunoblotting and both bound to an antigen at kDa. This contrasts with Patient DR the findings in a single patient with drug-induced lichen 1 11 29 14 4 8 1 4 planus pemphigoides whose serum immunoprecipitated 2 i 2S 8 14 8 71 NT the classical BP antigen.

DAVIS et ai. The BMZ is very complex, bearing many macromo- bullous and cicatrieial pemphigoid: a clinical and immunopatholo- lecules. Br j Dermatol , 18 Pothupitiya CM. Distribu- targets following basal cell damage.

In buUous I,K. Hr I Dermatol ; The use of chemically split tissue in the detection of circulating anti-basement membrane zone antibodies the classical BP antigen. It is of interest that sera from in bullous pemphigoid and cicatrical pemphigoid. Further molecular characterization is required to deter- 20 Beutner F.

Nisengard R[, Kumar V. Fosse M et al. A routine inimunoelcctron- microscope technique for localising an antibody on epidermal basement membrane. Nature Lichen rubcr pemphigoides. Electrophoretic transfer of 1S 34 Cliii ilxp Dermatol 1SH9; 1 Coexistence of lichen planus and bullous 25 Black MM. What is going on in lichen planus? Ciin Exp Dermatoi pemphigoid. An immunopathological study.

Pemphigoid antibody 5 RekanI ST. Lichen piiinus anJ bullous pemphigoid. Arch DerimUol mediated attachment of peripheral blood leukocytes at the dermal- f : lAlJ.

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Br;intlcy B. Lichen pliinus pemphigoides: 3 3 8. Isolation of complementary Dermatol 1 9 8 1 8: n i - 6. UNA for bullous pemphigoid antigen by use of patients' aiitoanti- 12 Oomen C. Temmerman L, Kint A. I Clin Invest ; 82; , Clin F. Takahashi Y et al. Definition of bullous 1 3 Souteyrand P. Lichen planus pemphigoid antibody binding to intracellular and extracellular pemphigoides. Laroche L el al. Lichen planus pemphigoides: 34 Westgale CF. Br I Dirnuttol antigen localisation suggests an intracellular association with i I Interaction of intermediate filaments with the antigen by SVtranslbrmed human keratinocytes.

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