Clinical and Serological Transition From Pemphigus Vulgaris to Pemphigus Foliaceus Demonstrated by Desmoglein ELISA System

Tsuji, Yukiko; Kawashima, T.; Yokota, Koichi; Tateish, Yasuki; Tomita, Yoshihiko; Matsumura, Tomohiro; Shimizu, Hiroshi

doi:10.1001/archderm.138.1.95

Cited by 30 publications

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“…A few cases have been reported in the literature. Earlier cases were confirmed by histology and immunoblotting [1,2,3,4,5,6] while the transition in more recent cases has been demonstrated by a change in desmoglein (Dsg) 1 and 3 autoantibody profile by Dsg ELISA testing [6,7,8,9,10,11]. We report 3 cases that showed transition from PV to PF confirmed by Dsg ELISA.…”

Section: Introductionmentioning

confidence: 77%

“…In the literature, there are at least 16 reported cases of transition of PV to PF [1,2,3,4,5,6,7,8,9,10,11] including one that reverted to PV again [7] (table 1). In contrast, there are only 3 reported cases of transition from PF to PV [1, 6, 7] and 3 cases of PV-PF overlap [4, 6].…”

Section: Discussionmentioning

confidence: 99%

“…The majority of cases of transition from PV to PF were reported by the Japanese [1,2,3,6,7,8,9]. Most of the earlier cases were confirmed on immunoblotting during the PF stage [1,2,3, 6] while in the cases reported over the past 3 years, the change in autoantibody profile has been demonstrated using Dsg ELISA [6,7,8,9,10,11]. One recent case report of transition from PV to PF documented rising Dsg1 antibody levels and decreasing Dsg3 antibody levels by ELISA with subsequent disappearance of Dsg3 antibodies while on prednisolone and immunosuppressives [11].…”

Section: Discussionmentioning

confidence: 99%

“…Among the cases reported previously, 3 were not under any treatment at the onset of the PF stage [2, 10], 2 were on immunosuppressives [1, 11], 3 were on low-dose systemic corticosteroids [3, 7, 8] and 1 was on moderate doses of systemic corticosteroids [9]. There was no mention of treatment in the remaining patients.…”

Section: Discussionmentioning

confidence: 99%

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Three Cases of Transition from Pemphigus vulgaris to Pemphigus foliaceus Confirmed by Desmoglein ELISA

Ng¹,

Thng²

2005

Dermatology

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We report 3 cases of pemphigus vulgaris (PV) confirmed by histology and direct and indirect immunofluorescence that showed transition to pemphigus foliaceus (PF) 2–4 years from the time of disease onset. Desmoglein (Dsg) ELISA testing of the sera from these 3 patients in the later stages of their disease showed the presence of anti-Dsg1 antibodies and the absence of anti-Dsg3 antibodies. These patients were on prednisolone and immunosuppressives at the time the sera were tested, and it is unclear if the transition from PV to PF is a permanent one or whether it is due to preferential suppression of Dsg3 antibodies below a certain threshold. Previously reported cases of transition from PV to PF and PF to PV are summarized.

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Section: Introductionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Three Cases of Transition from Pemphigus vulgaris to Pemphigus foliaceus Confirmed by Desmoglein ELISA

Ng¹,

Thng²

2005

Dermatology

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“…However, transition from PV to PF or vice versa may be observed [63][64][65]. More rarely, transition to BP has been reported [65].…”

Section: Clinical Featuresmentioning

confidence: 99%

Pemphigus: Subtypes, Clinical Features, Diagnosis, and Treatment

Kılıç¹

2018

Autoimmune Bullous Diseases

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Pemphigus is a group of autoimmune blistering disorders associated with autoantibodies against the keratinocyte cell surface. Pemphigus has three major variants: pemphigus vulgaris (PV), pemphigus foliaceus (PF), and paraneoplastic pemphigus (PNP) which all have further subtypes. The variants of pemphigus are classified depending upon the clinical and histological features, immunofluorescence staining pattern, and autoantibody profile of the disease. The onset and course of pemphigus appear on the basis of interaction between genetic predisposition and various triggering factors. Pemphigus vulgaris is the most commonly seen and representative clinical form of pemphigus. Together with clinical manifestations, the histopathological and immunopathological data support the diagnosis. As though some pemphigus variants, particularly pemphigus vulgaris and paraneoplastic pemphigus, have a mortality risk, early diagnosis is necessary and onset of treatment should be promptly initiated. In this chapter, firstly, classification of pemphigus is described. After then, clinical features, histopathological and immunopathological findings, target antigens, etiopathogenesis and comorbidities of each pemphigus variant are discussed briefly.Keywords: pemphigus, pemphigus variants, clinical manifestations, pathogenesis, histopathology, immunopathology IntroductionPemphigus is a distinct organ-specific autoimmune blistering disorder involving skin and mucous membranes associated with autoantibodies directed against desmosomes-intercellular adhesive molecule complex localized on the keratinocyte cell surface [1][2][3][4].© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Pemphigus has three major variants, which are classified depending on the basis of the clinical, histological features, immunofluorescence staining pattern and autoantibody profile of the disease including pemphigus vulgaris (PV), pemphigus foliaceus (PF), and paraneoplastic pemphigus (PNP), which all have further subtypes. Less frequently seen and newer variants of pemphigus include IgA pemphigus (IGAP) and pemphigus herpetiformis (PH) [1-6].The term "pemphigus" origins from the Greek word "pemphix", which has a meaning of "blister" [1]. It is a chronic potentially life-threating bullous disorder if not treated on time [4,7,8]. The phenotypes of pemphigus represent a complex spectrum with multiple genetic and environmental factors playing a role in disease pathogenesis [9,10].Together with clinical manifestations, the histopathological and immunopathological data support the diagnosis of the disease. The best site for the cutaneous biopsy for the appropriate histopathological examination is a fresh (< 24 h) small vesicle or 1/3 of the peripheral portion of the blister including the perilesional normal appearing s...

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