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Clinical, histopathologic, and therapeutic aspects of subepidermal autoimmune bullous diseases with IgG on the floor of salt-split skin
Authors:Maria A Barnadas  MD    M José González  MD    Mercè Planagumà  MD    Jordi Romaní  MD    Román Curell  MD    José M de Moragas  MD  and Agustí Alomar  MD
Institution:Department of Dermatology and Pathology, Hospital de la Sta. Creu i St Pau, C/St Antoni M Claret, 167, 08025 Barcelona, Spain.
Abstract:BACKGROUND: About 12% of patients with subepidermal autoimmune bullous disease and immunoglobulin G (IgG) at the dermal-epidermal junction present diseases other than bullous pemphigoid. MATERIALS AND METHODS: We report the clinical, histopathologic, and therapeutic aspects of eight cases of subepidermal bullous disorder with IgG on the floor of salt-split skin. RESULTS: A predominant neutrophilic infiltrate was detected in six of the eight patients. In one patient, the inflammatory infiltrate was neutrophilic and eosinophilic in the same proportion. A good response to dapsone alone or combined with prednisone was observed in six patients. CONCLUSIONS: The salt-split skin direct immunofluorescence test is useful for its diagnostic and therapeutic implications.
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