Erosive lichen planus of the vulva: weak circulating basement membrane zone antibodies are present

Abstract

The objective of this study was to investigate whether circulating basement membrane zone (BMZ) antibodies are present in erosive lichen planus (LP) of the vulva. In total, 56 consecutive women with biopsy-confirmed erosive LP of the vulva were recruited from a vulval clinic in a district general hospital and teaching hospital in Oxfordshire. Indirect immunofluorescence (IgG and IgA) was performed on 56 sera, and 15 were tested to IgG subclasses (1-4). Immunoblotting was carried out on salt-split and urea-extracted epidermal skin extracts on 11. The main outcome measure was the presence or absence of staining at the BMZ. Of the 56 sera, 34 (61%) had weak (neat or 1 : 5) epidermal-binding BMZ antibodies (25 had IgG, 5 had IgA, 4 had both IgG and IgA). All 15 sera tested to IgG showed epidermal binding to one or more IgG subclasses: IgG1 (7 sera), IgG2 (7), IgG3 (7) and IgG4 (0). Immunoblotting identified IgG antibodies to bullous pemphigoid (BP)180 (10/11) and BP230 (2/11). The majority (61%) of patients with vulval erosive LP had circulating serum IgG BMZ antibodies, chiefly reacting with BP180. There was subclass restriction of the IgG response to IgG1, 2 and 3. The significance of these antibodies is uncertain, but they may be a marker for the disease.

Vulvar dermatosis

“…A study of 126 women with adult-onset VLP found that autoimmune conditions, mainly thyroid disease, were significantly more frequent in patients with VLP than in examined controls (29% and 11.8% with at least one autoimmune disorder, respectively) [32]. Anti-membrane-zone antibodies chiefly targeting BP180 are present in 61% of erosive LP sera, also suggesting that autoimmune mechanisms may be important in its pathogenesis [32]. The association between LP and hepatitis C has been also studied but the results are contradictory.…”

“…Like for LS, an autoimmune aetiology of LP is supported by the association with autoimmune disorders, family history of autoimmunity and circulating organ-specific antibodies. A study of 126 women with adult-onset VLP found that autoimmune conditions, mainly thyroid disease, were significantly more frequent in patients with VLP than in examined controls (29% and 11.8% with at least one autoimmune disorder, respectively) [32]. Anti-membrane-zone antibodies chiefly targeting BP180 are present in 61% of erosive LP sera, also suggesting that autoimmune mechanisms may be important in its pathogenesis [32].…”

Non‐Infective Cutaneous Conditions of the Vulva

“…Weak circulating basement membrane zone antibodies have been shown to be present in 61% of patients with erosive lichen planus of the vulva (Cooper et al 2005). Lichen planus-like eruptions can be produced by drugs and are seen in GVHD.…”

The Association of Lichen Sclerosus and Erosive Lichen Planus of the Vulva With Autoimmune Disease

“…However, antibasement membrane zone antibodies chiefly targeting BP180 are present in 61% of erosive LP sera, suggesting that autoimmune mechanisms may be important in its pathogenesis. 6 The aim of this study was to investigate the prevalence of autoimmune disease and circulating autoantibodies in adult women with vulval LS and erosive LP of the vulva and to compare these with a control population. …”