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Localized linear IgA disease responding to colchicine
Author(s) -
Benbenisty Keith M.,
Bowman Paul H.,
Davis Loretta S.
Publication year - 2002
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1046/j.1365-4362.2002.01321.x
Subject(s) - dermoepidermal junction , medicine , blisters , pathology , dermatology , biopsy , skin biopsy , direct fluorescent antibody , dermis , antibody , immunology
A 64‐year‐old white woman presented to our clinic with a 3‐month history of multiple blisters on her right breast which had been unresponsive to acyclovir, amoxicillin/clavulanate and fluconazole. She denied taking any antibiotics prior to the eruption. Physical examination revealed grouped vesicles on an erythematous base and shallow ulcerations in an annular pattern localized to the right breast, without areolar involvement ( Fig. 1). There were no oral or mucosal lesions. Past medical history was significant only for a distant history of uterine carcinoma which had been successfully treated with hysterectomy/oophorectomy. No history of liver or autoimmune disease was present. Further examination failed to reveal any history of unusual contact allergens. There was no family history of similar eruptions. 1Shallow ulcerations and blisters on erythematous bases in an annular pattern Punch biopsy specimen from lesional skin revealed a subepidermal blister with a dermal infiltrate consisting of numerous neutrophils and scattered eosinophils ( Fig. 2). Direct immunofluorescence of perilesional skin demonstrated the presence of a homogeneous linear band of IgA deposits along the dermoepidermal junction and in dermal microvascular basement membranes ( Fig. 3). IgG and C3 immunoreactants were not identified. 2Subepidermal blister with a dermal infiltrate consisting of numerous neutrophils and scattered eosinophils (hematoxylin & eosin, × 20)3Linear deposits of IgA along the dermoepidermal junction and in dermal microvascular basement membranes (direct immunofluorescence of perilesional skin, × 40) After starting the patient on oral colchicine, 0.6 mg twice daily, no new blisters appeared, and within 1 week the eruption was nearly resolved. The patient tolerated therapy without any side‐effects, and at a follow‐up visit 5 weeks later had only minimal postinflammatory changes on the skin of the right breast. She then discontinued colchicine and remains free of any recurrence 6 months later.