Case of linear IgA bullous dermatosis-involved ulcerative colitis

✍ Scribed by Tomonori Taniguchi; Hideki Maejima; Norimitsu Saito; Kensei Katsuoka; Satomi Haruki

• Book ID: 102267893
• Publisher: John Wiley and Sons
• Year: 2009
• Tongue: English
• Weight: 254 KB
• Volume: 15
• Category: Article
• ISSN: 1078-0998
• DOI: 10.1002/ibd.20795

✦ Synopsis

Case of Linear IgA Bullous Dermatosisinvolved Ulcerative Colitis

To the Editor:

There are a number of reports of linear IgA bullous dermatosis (LABD) associated with preexisting inflammatory bowel disease (IBD), in particular ulcerative colitis (UC). 1 We report the case of a patient who developed LABD while receiving treatment for UC. A 28year-old female. UC was diagnosed 1 year ago by colonoscopy (Fig. 1a) and biopsy specimen (Fig. 1b). She was receiving oral mesalazine at 2250 mg daily and prednisolone at 5 mg daily, and her disease activity was well controlled. However, within a few days after she developed a disease relapse, with severe diarrhea and bloody stool, the patient also developed bullae with pruritus on her trunk, gluteal region, and axillary fossa. She was therefore referred to our department.

She had noticed clear and tender vesicles and bullae on erosion not associated with erythematous plaques on her trunk and limbs (Fig. 1c). There were no mucosal lesions. Routine laboratory examinations revealed evidence of an acute inflammatory reaction (white blood cell count, 11,000/L, serum and an elevated erythrocyte sedimentation rate [ESR] of 77 mm/h). An immunological study was performed, including serological tests to determine the presence of autoantibodies, complement levels, rheumatologic markers and immunoglobulin levels, and thyroid tests; however, no significant abnormalities were detected. The skin biopsy specimen showed subepidermal neutrophilrich bullae. Direct immunofluorescence