Linear IgA bullous dermatosis in one of two piroxicam-induced eruptions: A distinct direct immunofluorescence trend revealed by the literature

Plunkett, Richard W.; Chiarello, Stephen E.; Beutner, Ernst H.

doi:10.1067/mjd.2001.117390

Cited by 39 publications

(25 citation statements)

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“…Na forma adulta, que surge após a puberdade, o quadro clínico assemelha-se à DH ou ao PB e o acometimento mucoso é mais comum (2) . Há evidências na literatura de associação, em alguns casos, do surgimento de DbIgA ao uso de medicamentos (10) . O exame histopatológico evidencia a clivagem subepidérmica com infiltrado inflamatório rico em polimorfonucleares, principalmente neutrófilos, mas contendo, também, eosinófilos.…”

Section: Discussionunclassified

A necessidade da imunofluorescência direta no diagnóstico da dermatose bolhosa por IgA

Chang¹

2012

J. Bras. Patol. Med. Lab.

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A dermatose bolhosa por imunoglobulina da classe A linear (DbIgA) do adulto é uma doença autoimune rara caracterizada por formação de bolhas subepidérmicas e depósito linear de imunoglobulina da classe A (IgA) na zona da membrana basal (ZMB). Por possuir aspectos clínicos e histológicos semelhantes a outras dermatoses bolhosas, principalmente a dermatite herpetiforme e o penfigoide bolhoso, faz-se necessária a realização de imunofluorescência direta para confirmação diagnóstica. Apresenta-se então, neste artigo, relato de caso ilustrando essa necessidade.

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Section: Discussionunclassified

A necessidade da imunofluorescência direta no diagnóstico da dermatose bolhosa por IgA

Chang¹

2012

J. Bras. Patol. Med. Lab.

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“…al. [1], all the cases we have encountered of LAD were associated with a drug reaction. Thus, LAD cases should be confirmed by DIF; a search should be made for any drug eliciting the disorder.…”

Section: Discussionmentioning

confidence: 99%

“…The cause of the disease is unknown, but the eruption has been most commonly associated with selected medications [1][2][3][4][5].…”

Section: Discussionmentioning

confidence: 99%

“…The distribution of lesions and the course of the disease differ from those of the idiopathic form of linear IgA blistering disease (LABD). LABD is extremely rare, and thus not as well characterized as LAD [1][2][3][4][5].…”

Section: Linear Iga Bullous Disease With Possible Immunoreactivity Tomentioning

confidence: 99%

“…Ana Maria Abreu Velez 1 , Vickie M. Brown 2 , Michael S. Howard Introduction Drug-induced linear IgA (LAD) is a self-limited eruption, characterized by linear deposition of IgA without IgG at the basement membrane zone (BMZ) of the dermal/epidermal junction of the skin. Most patients described with this condition seem to lack circulating antibodies.…”

Section: Linear Iga Bullous Disease With Possible Immunoreactivity Tomentioning

confidence: 99%

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Linear IgA bullous disease with possible immunoreactivity to the basement membrane zone and dermal blood vessels

Velez¹,

Brown²,

Howard³

2014

Our Dermatol Online

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Introduction: Linear IgA bullous dermatosis (LAD) is an immunobullous disorder, in which IgA antibodies are deposited along the basement membrane zone (BMZ) of the skin in a linear pattern. The cause of this disease is unknown, but the eruption may occur more commonly in association with certain medications. Case report: A 61 year old woman presented with blisters in the axillae and legs, with pain, itching and swelling. She was taking many medications for other conditions such diabetes and obesity. Tense blisters were seen, primarily on the legs and accompanied by some ankle swelling. Methods: Skin biopsies for hematoxylin and eosin (H&E) examination, as well as for direct immunofluorescence (DIF), and immunohistochemistry (IHC) studies were performed. Results: The H&E examination revealed a subepidermal blister, with small numbers of lymphocytes, neutrophils and eosinophils noted within the blister lumen. The dermis also displayed a mild, superficial, perivascular infiltrate of lymphocytes and histiocytes; eosinophils and neutrophils were also noted. DIF and IHC studies confirmed the diagnosis of linear IgA (LAD) at the BMZ. However, in addition to immunoglobulin A, we also observed deposits of IgA, IgM, IgG, IgD, Kappa, Lambda, Complement/C3c, C1q, fibrinogen and albumin around upper dermal blood vessels. Conclusions: LAD has been most commonly associated with medication intake; the most common DIF immune response is the presence of linear IgA at the BMZ. However, here we found additional reactivity to against dermal blood vessels. Because the patient is affected by diabetes mellitus, it is difficult to know if the observed vascular reactivity was associated with the diabetes or solely an immune reaction to the vessels. Based on our findings, we encourage searching for vascular reactivity in cases of LAD.Key words: Linear IgA bullous dermatosis; drugs; vessels; autoreactivity Abbreviations: Linear IgA bullous dermatosis (LAD), basement membrane zone (BMZ), direct immunofluorescence (DIF), hematoxylin and eosin stain (H&E), idiopathic linear IgA blistering disease (LABD).

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Immunobullous Diseases

Wojnarowska¹,

Venning²,

Burge³

2004

Rook's Textbook of Dermatology

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Linear IgA bullous dermatosis in one of two piroxicam-induced eruptions: A distinct direct immunofluorescence trend revealed by the literature

Cited by 39 publications

References 0 publications

A necessidade da imunofluorescência direta no diagnóstico da dermatose bolhosa por IgA

A necessidade da imunofluorescência direta no diagnóstico da dermatose bolhosa por IgA

Linear IgA bullous disease with possible immunoreactivity to the basement membrane zone and dermal blood vessels

Immunobullous Diseases

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