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Selective Deposition of Monomer IgA1 in the Intercellular Space of the Epidermis

Yuichi Teraki, MD; Naoko Amagai, MD; Takashi Hashimoto, MD; Toshio Kusunoki, MD; Takeji Nishikawa, MD

Arch Dermatol. 1991;127(2):221-224.

Abstract
• We describe a 7-year-old girl with recurrent pruritic vesiculopustular lesions involving the trunk, extremities, face, and oral mucosa. Histopathologic examination revealed intraepidermal bullae containing neutrophils and eosinophils, and direct immunofluorescence test showed the deposition of IgA in the intercellular space of the epidermis. Circulating IgA anti-intercellular antibodies were also detected by indirect immunofluorescence test. Immunofluorescence studies using monoclonal antibodies to human IgA subclasses showed that these IgA antibodies belonged to IgA¹. Antisera against J chain and secretory component did not show any specific intercellular staining. Surface IgA⁺-B cells were transiently increased in the peripheral blood during the active stage of the disease. These results indicated the extragut origin of these IgA antibodies. Dapsone therapy was shown to be very effective.

(Arch Dermatol. 1991;127:221-224)

Author Affiliations
From the Department of Dermatology, Keio University School of Medicine (Drs Teraki, Amagai, Hashimoto, and Nishikawa), and Kusunoki Dermatology Clinic (Dr Kusunoki), Tokyo, Japan.

Footnotes
Accepted for publication August 11, 1990.

Reprint requests to Department of Dermatology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160, Japan (Dr Teraki).

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