Mucous membrane pemphigoid with autoantibodies to all the laminin 332 subunits and fatal outcome resulting from liver cirrhosis and hepatocellular carcinoma

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Mucous membrane pemphigoid with autoantibodies to all the laminin 332 subunits and fatal outcome resulting from liver cirrhosis and hepatocellular carcinoma Teruki Dainichi, MD, Youichirou Hirakawa, MD, Norito Ishii, MD, Bungo Ohyama, MD, Futoshi Kohda, MD, Masakazu Takahara, MD, Yoichi Moroi, MD, Masutaka Furue, MD, Shinichiro Yasumoto, MD, Takashi Hashimoto, MD Journal of the American Academy of Dermatology Volume 64, Issue 6, Pages 1199-1200 (June 2011) DOI: 10.1016/j.jaad.2009.09.013 Copyright © 2010 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 Immunoblot analyses. Using dermal extracts (left column), IgG autoantibodies of control epidermolysis bullosa acquisita serum reacted with the 290-kDa type VII collagen (lane 1), and immunoglobulin G (IgG) autoantibodies of control antilaminin γ1 pemphigoid (formerly anti-p200 pemphigoid) serum reacted with 200-kDa laminin γ1 (lane 2), whereas neither antigen was detected by our patient's serum (lane 3). Using purified human laminin 332 (right column), IgG antibodies of this patient's serum reacted with all the 165-kDa α3, 145-kDa α3, 140-kDa β3, and 105-kDa γ2 subunits of laminin 332 (lane 1). IgG antibodies of control MMP serum 1 reacted with the 165- and 145-kDa α3 subunits (lane 2), and IgG antibodies of control MMP serum 2 reacted with the 105-kDa γ2 subunit (lane 3), while normal serum showed no reactivity (lane 4). Journal of the American Academy of Dermatology 2011 64, 1199-1200DOI: (10.1016/j.jaad.2009.09.013) Copyright © 2010 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 Clinical manifestations in the terminal stage of the present case. A, Fresh, large, well demarcated erosions without perilesional erythema on the left upper arm. B, Ulcers on the oral mucosa and tongue. Journal of the American Academy of Dermatology 2011 64, 1199-1200DOI: (10.1016/j.jaad.2009.09.013) Copyright © 2010 American Academy of Dermatology, Inc. Terms and Conditions