Ko Christine J, Colegio Oscar R, Moss Jeremy E, McNiff Jennifer M
Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA.
J Cutan Pathol. 2010 Apr;37(4):475-7. doi: 10.1111/j.1600-0560.2009.01472.x. Epub 2009 Nov 16.
Dermatitis herpetiformis has characteristic clinical and histopathologic findings. A fibrillar pattern of IgA deposition on direct immunofluorescence in dermatitis herpetiformis is underreported. Here, we describe three patients with the fibrillar pattern of IgA deposition on direct immunofluorescence examination that initially misled diagnosis in one of the three. Interestingly, two of the three patients lacked anti-transglutaminase and anti-endomysial antibodies but had a clinical course typical of dermatitis herpetiformis. Dermatitis herpetiformis may have a fibrillar rather than granular pattern of IgA deposition on direct immunofluorescent microscopy, and patients with this pattern of immunoglobulin deposition may lack circulating autoantibodies.
疱疹样皮炎有特征性的临床和组织病理学表现。疱疹样皮炎直接免疫荧光检查中IgA沉积的纤维状模式报道较少。在此，我们描述了3例在直接免疫荧光检查中有IgA沉积纤维状模式的患者，其中1例最初误诊。有趣的是，3例患者中有2例缺乏抗转谷氨酰胺酶和抗肌内膜抗体，但有典型的疱疹样皮炎临床病程。疱疹样皮炎在直接免疫荧光显微镜检查中可能有IgA沉积的纤维状而非颗粒状模式，有这种免疫球蛋白沉积模式的患者可能缺乏循环自身抗体。
