Recke Andreas, Rose Christian, Schmidt Enno, Bröcker Eva-Bettina, Zillikens Detlef, Sitaru Cassian
Department of Dermatology at University of Lübeck, Ratzeburger Allee 160, Lübeck 23538, Germany.
J Am Acad Dermatol. 2009 Aug;61(2):333-6. doi: 10.1016/j.jaad.2008.10.061.
Pemphigus and the pemphigoid group of diseases are distinct autoimmune conditions in which autoantibodies with different specificities cause skin blistering by different mechanisms. Transitions and associations between these two groups of autoimmune diseases are rare. Here, we report a patient with long-standing pemphigus foliaceus, in whom clinical remission was eventually induced. Shortly thereafter, he developed the clinical, histologic, and immunopathological changes of bullous pemphigoid. This case offered the rare opportunity to serologically monitor serum levels of both anti-BP180 and BP230 during the preclinical stage of bullous pemphigoid. Of interest, although the autoimmune response clearly shifted with regard to the target antigens, the patient's autoantibodies against desmosomal and hemidesmosomal components showed the same IgG subclass distribution.
天疱疮和类天疱疮疾病组是不同的自身免疫性疾病，其中具有不同特异性的自身抗体通过不同机制导致皮肤水疱形成。这两组自身免疫性疾病之间的转变和关联很少见。在此，我们报告一名患有长期落叶型天疱疮的患者，最终诱导其临床缓解。此后不久，他出现了大疱性类天疱疮的临床、组织学和免疫病理学变化。该病例提供了一个罕见的机会，可在大疱性类天疱疮临床前期血清学监测抗BP180和BP230的血清水平。有趣的是，尽管自身免疫反应在靶抗原方面明显发生了转变，但患者针对桥粒和半桥粒成分的自身抗体显示出相同的IgG亚类分布。
