Volume 4, Issue 4, Pages (May 2018)

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Volume 4, Issue 4, Pages 352-354 (May 2018) Explosive bullous pemphigoid with high serum total IgE: Serum IgE as a biomarker that reflects disease activity Hyun Jung Kwon, MD, Ga Ram Ahn, MD, Sun Young Choi, MD, PhD, Kapsok Li, MD, PhD, Seong Jun Seo, MD, PhD JAAD Case Reports Volume 4, Issue 4, Pages 352-354 (May 2018) DOI: 10.1016/j.jdcr.2017.09.011 Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 A, Multiple tiny bullous lesions around targetoid patches on both arms and trunk at admission. B, Rapid progression of disease included Nikolsky sign and severe erythroderma. C, Old crusted patches and newly formed bullae were admixed. JAAD Case Reports 2018 4, 352-354DOI: (10.1016/j.jdcr.2017.09.011) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 Subepidermal blisters and perivascular eosinophilic infiltrates in the superficial dermis and inside blisters. (A and B, Hematoxylin-eosin stain; original magnifications: A, ×100; B, ×400.) JAAD Case Reports 2018 4, 352-354DOI: (10.1016/j.jdcr.2017.09.011) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 3 Linear, continuous, and intense deposition of complement C3 in the basal membrane zone (A) and IgG deposition (B) on the epidermal side of the cleavage using an indirect salt split-skin study. (A, Direct immunofluorescence staining; original magnification: ×200.) (B, Indirect immunofluorescence staining; original magnification: ×200.) JAAD Case Reports 2018 4, 352-354DOI: (10.1016/j.jdcr.2017.09.011) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 4 Serologic levels of total serum IgE consistently increased over a period of 4 months. The clinical severity score assessed by ABSIS was generally consistent with serum total IgE level. ABSIS, Autoimmune Bullous Skin Disorder Intensity Score; IVIg, intravenous IgG; MMF, mycophenolate mofetil. JAAD Case Reports 2018 4, 352-354DOI: (10.1016/j.jdcr.2017.09.011) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions