Korean J Dermatol.  2002 Feb;40(2):170-173.

A Case of Bullous Pemphigoid with Severe Pruritus and Elevated Serum IgE Level

Affiliations
  • 1Department of Dermatology, Chonnam National University Medical School, Kwangju, Korea. yhwon@chonnam.chonnam.ac.kr

Abstract

Bullous Pemphigoid(BP) is a chronic non-hereditary autoimmune disease of the elderly characterized by subepidermal blisters due to autoantibodies targeted to hemidesmosome. An elevated serum IgE level and perepheral blood eosinophilia are observed in one-half of cases though their clinical relevance on disease activity is unclear. A 48-year-old woman presented with severe pruritus and recently developed multiple bullae. IgG antibody was deposited on the epidermal roof side on direct immunofluorescence study and 180 & 230 kD BP antigens were identified with immunoblotting analysis. Pruritus was so severe as not to be controlled by conventional antihistamine therapy, and serum IgE level was highly elevated during the intensely itching period. However, it dropped gradually with improvement of skin lesions and pruritus in response to systemic corticosteroid and azathioprine. This finding suggests a long-term follow-up of IgE levels is necessary to determine the disease activity in a peculiar BP.

Keyword

Bullous pemphigoid; IgE; pruritus

MeSH Terms

Aged
Autoantibodies
Autoimmune Diseases
Azathioprine
Blister
Eosinophilia
Female
Fluorescent Antibody Technique, Direct
Follow-Up Studies
Hemidesmosomes
Humans
Immunoblotting
Immunoglobulin E*
Immunoglobulin G
Middle Aged
Pemphigoid, Bullous*
Pruritus*
Skin
Autoantibodies
Azathioprine
Immunoglobulin E
Immunoglobulin G
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