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K. Wozniak, T. Hashimoto, N. Ishii, H. Koga, M. Huczek and C. Kowalewski Fluorescence overlay antigen mapping using laser scanning confocal microscopy differentiates linear IgA bullous dermatosis from epidermolysis bullosa acquisita mediated by IgA British Journal of Dermatology 168

Version of Record online: 28 FEB 2013 | DOI: 10.1111/bjd.12017

What’s already known about this topic?

  •  Linear IgA bullous dermatosis (LABD) is an autoimmune subepidermal blistering disorder mediated by circulating IgA antibodies mainly directed against LAD-1 antigen which is an extracellular domain of BP180.
  •  IgA-epidermolysis bullosa acquisita (IgA-EBA) is mediated by IgA antibodies to type VII collagen.
  •  On the basis of initial clinical features and routine immunofluorescence studies the entities are indistinguishable.

What does this study add?

  •  IgA-EBA may be distinguished from LABD on fluorescence overlay antigen mapping using laser scanning confocal microscopy (FOAM-LSCM).
  •  The study showed that FOAM-LSCM results are comparable to those obtained using immunoblotting and enzyme-linked immunosorbent assay.
  •  FOAM-LSCM is of special value in patients who show no circulating IgA antibodies.

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