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CPT Ramzi W. Saad, MC; Nouha Domloge-Hultsch, MD; Kim B. Yancey, MD; LTC Paul M. Benson, MC; COL William D. James, MC

Arch Dermatol. 1992;128(6):807-810.

Abstract
• Background.—
Childhood localized vulvar pemphigoid has been recently reported in four girls. A fifth child with this proposed rare variant of bullous pemphigoid is described. Moreover, findings in the various immunopathologic studies we performed establish this entity as a true morphologic variant of bullous pemphigoid.

Observations.—
In situ deposits of IgG in this patient's epidermal basement membrane zone localized to the epidermal side of 1 mol/L of saline-split skin. Moreover, the patient had circulating IgG autoantibodies that bound the epidermal side of 1 mol/L of saline-split skin in indirect immunofluorescence microscopy and immunoprecipitated the 230-kd bullous pemphigoid antigen from biosynthetically radiolabeled human keratinocyte extracts. These laboratory findings are identical to those documented in patients with the generalized "classic" form of bullous pemphigoid.

Conclusions.—
This study demonstrates that a child with clinical, histopathologic, and immunopathologic features of localized vulvar pemphigoid had circulating autoantibodies that identify a specific keratinocyte antigen, the bullous pemphigoid antigen, which may serve as a molecular marker for this disease.

(Arch Dermatol. 1992;128:807-810)

Author Affiliations
USA; USA; USA

From the Dermatology Service, Walter Reed Army Medical Center, Washington, DC (Drs Saad, Benson, and James), and the Uniformed Services University of the Health Sciences, Bethesda, Md (Drs Domloge-Hultsch and Yancey).

Footnotes
Accepted for publication February 12, 1992.

The opinion or assertions contained herein are the private views of the authors, and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.

Reprint requests to Dermatology Service, Walter Reed Army Medical Center, Washington, DC 20307 (Dr Saad).

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