TY - JOUR
T1 - Clinicopathologic features of IgG/IgA pemphigus in comparison with classic (IgG) and IgA pemphigus
AU - Toosi, Siavash
AU - Collins, Jeffrey W.
AU - Lohse, Christine M.
AU - Wolz, Michael M.
AU - Wieland, Carilyn N.
AU - Camilleri, Michael J.
AU - Bruce, Alison J.
AU - Mcevoy, Marian T.
AU - Lehman, Julia S.
N1 - Publisher Copyright:
© 2015 International Society of Dermatology.
PY - 2016/4/1
Y1 - 2016/4/1
N2 - Background: The pemphigus group is characterized by the presence of circulating immunoglobulins against desmosomes. IgG/IgA pemphigus is defined by the presence of IgG and IgA cell surface deposits upon direct immunofluorescence (DIF) and/or circulating IgG and IgA autoantibodies upon indirect immunofluorescence. Previous reports of patients with IgG/IgA pemphigus are sparse. Whether IgG/IgA pemphigus is best classified as a subtype of IgG (classic) pemphigus or IgA pemphigus, or as a distinct entity, has yet to be determined. Objectives: We compared the features of patients with IgG/IgA pemphigus to those of IgG pemphigus and IgA pemphigus. Methods: Retrospective clinicopathologic study of patients with IgG, IgG/IgA, and IgA pemphigus evaluated at our clinic (1993-2013). Results: We included 26, 13, and seven patients with IgG, IgG/IgA, and IgA pemphigus, respectively. Patients with IgG/IgA pemphigus did not differ significantly from patients with IgG pemphigus in terms of clinical and microscopic features, DIF findings, anti-desmoglein antibody values, and treatments required. However, patients with IgG/IgA pemphigus were significantly different from patients with IgA pemphigus regarding intertriginous distribution (P = 0.038) and pustular lesions (P < 0.001), acantholysis (P = 0.043), and presence of intercellular C3 deposits on DIF (P < 0.001). Conclusion: Comparative clinicopathologic data imply that IgG/IgA pemphigus may best be regarded as a variant of IgG pemphigus and distinct from IgA pemphigus.
AB - Background: The pemphigus group is characterized by the presence of circulating immunoglobulins against desmosomes. IgG/IgA pemphigus is defined by the presence of IgG and IgA cell surface deposits upon direct immunofluorescence (DIF) and/or circulating IgG and IgA autoantibodies upon indirect immunofluorescence. Previous reports of patients with IgG/IgA pemphigus are sparse. Whether IgG/IgA pemphigus is best classified as a subtype of IgG (classic) pemphigus or IgA pemphigus, or as a distinct entity, has yet to be determined. Objectives: We compared the features of patients with IgG/IgA pemphigus to those of IgG pemphigus and IgA pemphigus. Methods: Retrospective clinicopathologic study of patients with IgG, IgG/IgA, and IgA pemphigus evaluated at our clinic (1993-2013). Results: We included 26, 13, and seven patients with IgG, IgG/IgA, and IgA pemphigus, respectively. Patients with IgG/IgA pemphigus did not differ significantly from patients with IgG pemphigus in terms of clinical and microscopic features, DIF findings, anti-desmoglein antibody values, and treatments required. However, patients with IgG/IgA pemphigus were significantly different from patients with IgA pemphigus regarding intertriginous distribution (P = 0.038) and pustular lesions (P < 0.001), acantholysis (P = 0.043), and presence of intercellular C3 deposits on DIF (P < 0.001). Conclusion: Comparative clinicopathologic data imply that IgG/IgA pemphigus may best be regarded as a variant of IgG pemphigus and distinct from IgA pemphigus.
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U2 - 10.1111/ijd.13025
DO - 10.1111/ijd.13025
M3 - Article
C2 - 26566588
AN - SCOPUS:84960385359
SN - 0011-9059
VL - 55
SP - e184-e190
JO - International journal of dermatology
JF - International journal of dermatology
IS - 4
ER -