Linear IgA dermatosis associated with ulcerative colitis: complete and sustained remission after total colectomy

Abstract

Linear IgA dermatosis has been increasingly associated with inflammatory bowel diseases, particularly ulcerative colitis. A 13-year-old male patient with an 11-month history of ulcerative colitis developed vesicles, pustules and erosions on the skin of the face, trunk and buttocks and in the oral mucosa. The work-up revealed a neutrophil-rich sub-epidermal bullous disease and linear deposition of IgA along the dermoepidermal junction, establishing the diagnosis of linear IgA dermatosis. The patient experienced unsatisfactory partial control of skin and intestinal symptoms despite the use of adalimumab, mesalazine, prednisone and dapsone for some months. After total colectomy, he presented complete remission of skin lesions, with no need of medications during two years of follow-up. A review of previously reported cases of the association is provided here and the role of ulcerative colitis in triggering linear IgA dermatosis is discussed.

Review article: non‐malignant oral manifestations in inflammatory bowel diseases

“…Association of linear IgA bullous disease with CD 95 and with UC has been reported, including cases of successful treatment with infliximab 96 or even with colectomy. 97 Linear immunoglobulin A (IgA) dermatosis is an autoimmune subepidermal vesiculobullous disease that may be idiopathic or drug-induced. The clinical presentation is heterogeneous and appears similar to other blistering diseases, such as bullous pemphigoid and dermatitis herpetiformis.…”

Linear IgA and IgG bullous dermatosis

“…2 Some disease triggers reported include drugs (vancomycin, lithium, phenytoin, furosemide, captopril), infections, autoimmune diseases (post-streptococcal glomerulonephritis and inflammatory bowel disease, particularly ulcerative colitis), and lymphoproliferative disorders. 5 , 6 …”

Anti‐BP230 antibody–positive bullous pemphigoid complicated by ulcerative colitis

“…BP180 NC16a was not detectable through chemiluminescent enzyme immunoassay (MBL, Nagoya, Japan), but an IgG enzyme-linked immunosorbent assay (ELISA) for BP230, which was examined in the manner To our knowledge, 28 cases of linear IgA bullous dermatosis (LAD) and 24 cases of BP180-type BP associated with UC have been reported. [3][4][5][6][7][8][9] Therefore, this is the first case of BP230-type BP associated with UC. According to previous reports, the patients all developed UC before BP, with a range of 6 months to 23 years between diagnoses.…”