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首页> 外文期刊>Our Dermatology Online >Linear IgA bullous disease with possible immunoreactivity to the basement membrane zone and dermal blood vessels
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Linear IgA bullous disease with possible immunoreactivity to the basement membrane zone and dermal blood vessels

机译：线性IgA大疱性疾病，可能对基底膜区和真皮血管产生免疫反应

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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
机译：简介：线性IgA大疱性皮肤病（LAD）是一种免疫球疾病，其中IgA抗体以线性模式沿着皮肤的基底膜区（BMZ）沉积。该病的病因尚不清楚，但与某些药物联合使用时，喷发可能更常见。病例报告：一名61岁的女性在腋窝和腿部出现水泡，疼痛，发痒和肿胀。她正在服用许多其他药物来治疗其他疾病，例如糖尿病和肥胖。可见强烈的水泡，主要在腿上，并伴有一些踝关节肿胀。方法：对苏木精和曙红（H＆E）进行皮肤活检，以及直接免疫荧光（DIF）和免疫组化（IHC）研究。结果：H＆E检查显示表皮下水疱，在水疱腔内发现少量淋巴细胞，嗜中性粒细胞和嗜酸性粒细胞。真皮还表现出轻度，浅表，血管周围的淋巴细胞和组织细胞浸润。还注意到嗜酸性粒细胞和嗜中性粒细胞。 DIF和IHC研究证实了BMZ诊断为线性IgA（LAD）。但是，除了免疫球蛋白A外，我们还观察到了真皮上血管周围IgA，IgM，IgG，IgD，Kappa，Lambda，补体/ C3c，C1q，纤维蛋白原和白蛋白的沉积。结论：LAD最常与药物摄入有关;最常见的DIF免疫反应是BMZ中存在线性IgA。但是，我们在这里发现了针对真皮血管的其他反应性。因为患者受到糖尿病的影响，所以很难知道观察到的血管反应性是否与糖尿病有关，或者仅仅是与血管的免疫反应有关。根据我们的发现，我们鼓励寻找LAD患者的血管反应性

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