Polymorphic pemphigoid

Abstract

We describe 20 patients with a chronic polymorphic eruption; they shared clinical, histopathological, and therapeutic features of both dermatitis herpetiformis and bullous pemphigoid (BP). In 14 of these 20 cases, direct and indirect immunofluorescence studies corresponded to BP. The remaining six patients showed IgA deposits in a linear pattern at the basement membrane zone, and two of these six showed IgA pemphigoid antibodies in their sera as well. No significant clinical and histological differences were detected in the patients, in connection with the immunological findings. Furthermore, one patient's condition, which was studied by repeated immunofluorescence examinations, changed from a linear IgA pattern and a negative indirect test to a linear IgG pattern and a positive reaction for IgG pemphigoid antibodies. We concluded that these cases constitute a polymorphic variant of BP.

Polymorphic Pemphigoid

“…In this vesicular variant of bullous pemphigoid, high-dosage prednisone was usually required for a long-term control of the disease, as in classical bullous pemphigoid. On the contrary, the patients reported by Honeyman et al [1] who exhibited linear IgA deposits at the BMZ by direct IF. would now be referred to as linear IgA dermatitis.…”

“…The term polymorphic pemphigoid was first intro duced by Honey man et al [ 1] in 1979. and has since been used in the literature as a clinical variant of bullous pem phigoid [2][3][4][5]. This concept of polymorphic pemphigoid is based on the data of 20 patients which were reported in the paper of Honeyman et al [1].…”

“…This concept of polymorphic pemphigoid is based on the data of 20 patients which were reported in the paper of Honeyman et al [1]. All these patients had a chronic polymorphic eruption which variably associated clinical signs of both dermatitis herpetiformis (i.e.…”

“…Honeyman et al [ 1] have reported patients who may be classified under two separate entities, when considering their immuno-pathological findings. The patients who exhibited linear IgG deposits at the BMZ by direct IF must be considered as true bullous pemphigoid with some atypical clinical aspects of dermatitis herpetiformis.…”

A Case of Linear IgA Bullous Dermatosis of Childhood: Immunoelectron Microscopic and IgA Subclass Studies

“…A variety of terms, namely benign chronic bullous dermatosis of childhood [ 1], juvenile der matitis herpetiformis \2-A\, bullous childhood disease [5], chronic bullous dermatosis of childhood [6,7] reflect the debatable nature of this entity. Moreover, in adults, simi lar diseases characterized by linear IgA deposits are called intermediate and mixed forms of DH and BP [8], IgA bullous pemphigoid [9], polymorphic pemphigoid [10] or linear DH [11]. In 1979, Chorzelski et al [12] defined this disease entity as linear IgA bullous dermatosis (LAD) and they divided it into two types, one for adults and the other for children.…”