Pemphigoid with antibodies to laminin [gamma]1, BP180 and BP230, associated with psoriasis vulgaris: Successful disease control with cyclosporin

• Published in: Journal of dermatology 2015-04, Vol.42 (4), p.394
• Main Authors: Imanishi, Akiko, Tateishi, Chiharu, Imanishi, Hisayoshi, Sowa-Osako, Junko, Koga, Hiroshi, Tsuruta, Daisuke, Hashimoto, Takashi
• Format: Article
• Language: English
• ISSN: 0385-2407; 1346-8138
• DOI: 10.1111/1346-8138.12798

Both anti-laminin [gamma]1 pemphigoid and bullous pemphigoid are autoimmune subepidermal blistering diseases. The former is rare and characterized by autoantibodies to laminin [gamma]1, a 200-kDa dermal protein, while the latter is common among the elderly and characterized by autoantibodies to BP180 and BP230, both of which are hemidesmosomal proteins. We experienced a 69-year-old Japanese male patient with blister formation secondary to erythrodermic psoriasis, which was successfully treated with cyclosporin. The histopathology of erythema corresponded with psoriasis and that of a blistering lesion showed infiltration of neutrophils and eosinophils in and around the subepidermal blisters. Patient immunoglobulin G antibodies labeled both the epidermal and dermal sides of 1 mol/L NaCl-split human skin by indirect immunofluorescent microscopy and recognized laminin [gamma]1, BP180 and BP230 by immunoblotting. To the best of our knowledge, this is the first report of coexistence of psoriasis and atypical pemphigoid with these three autoantibodies.