Drug-Induced Linear Immunoglobulin-A Bullous Dermatosis

Abstract

Studies on the target antigens in idiopathic LABD have identified a number of different antigens, including a 97-kDa antigen shown to be an anchoring filament; two antigens corresponding to the bullous pemphigoid (BP)-associated antigen and the epidermolysis bullosa acquisita (EBA)-associated antigen;20–23 and a number of other antigens including a 285-kDa24,25 and a 255kDa26 antigen (Fig 1). These findings suggest the heterogeneity of idiopathic LABD. Recently, the target antigens of three patients with drug-induced LABD have been identified.18 Immunoelectron microscopy showed the antibodies to be localized in the lamina lucida, in both the lamina lucida and the lamina densa, and in both the lamina densa and sublamina densa regions. Western immunoblotting of these patients’ serum identified an IgA that reacted to a 230-kDa protein that co-migrated with the BP-associated antigen in one patient and an IgA that reacted with a 97-kDa antigen in a second patient, this being presumably the anchoring filament antigen detected in the studies on idiopathic LABD.