Rapid response of IgA pemphigus of subcorneal pustular dermatosis type to treatment with isotretinoin.
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| Abstract |
Diagnosing IgA pemphigus and distinguishing between its 2 subtypes, intraepidermal neutrophilic IgA dermatosis type and subcorneal pustular dermatosis type, is important because treatment of IgA pemphigus has to be different from treatment of other blistering autoimmune dermatoses. We present a patient with subcorneal pustular dermatosis type of IgA pemphigus who rapidly responded to systemic treatment with isotretinoin. Specific diagnosis was established by detecting IgA serum activity to desmocollin 1 by indirect immunofluorescence microscopy on unfixed COS7 cells transfected with desmocollin 1. No IgA or IgG serum reactivity was found to recombinant forms of desmogleins 1 and 3 by an antigen-specific enzyme-linked immunosorbent assay. The disease was not effectively controlled by conventional therapeutic regimens. Systemic treatment with isotretinoin 20 mg daily led to complete clearance of skin lesions within 3 weeks. Assaying IgA serum reactivity to desmocollin 1, desmoglein 1, and desmoglein 3 as a valuable method for establishing the diagnosis and differentiating the 2 subtypes of IgA pemphigus. Isotretinoin was an effective drug in the treatment of subcorneal pustular dermatosis type of IgA pemphigus in this patient.
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| Authors | C Gruss, D Zillikens, T Hashimoto, M Amagai, M Kroiss, T Vogt, M Landthaler, W Stolz |
| Journal | Journal of the American Academy of Dermatology (J Am Acad Dermatol) Vol. 43 Issue 5 Pt 2 Pg. 923-6 (Nov 2000) ISSN: 0190-9622 [Print] United States |
| PMID | 11044824 (Publication Type: Case Reports, Journal Article) |
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