PMC6703093_01
Initial clinical presentation of the cutaneous irAE with vesicles and pustules on the volar skin and the soles.
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F1
Concurrently, the patient developed small vesicles and pustules on the medial aspects of her palms and soles (Figure 1).
Progression of skin lesions with (A) blisters and erosions affecting the lower arms and dorsal hands and (B) lichenoid papules on the buttocks and thighs.
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F2
Despite the application of topical corticosteroids (methylprednisolone cream) both the number and size of these lesions increased (Figure 2A). The patient also developed lichenoid papules and plaques on the legs and buttocks (Figure 2B).
Routine laboratory diagnostic with (A) deposition of IgG (indicated by arrows) at the epidermal side of human split skin, and (B) detection of anti-LAD IgG autoantibodies by immunoblot on concentrated supernatant of cultured keratinocytes. The arrow indicates the signal identified as LAD-1.
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F3
IF microscopy on both monkey esophagus and human salt-split skin (Figure 3A). Therefore, the serum was subsequently examined for the presence of anti-LAD-1 IgG antibodies by immunoblot, using concentrated supernatant of cultured keratinocytes as the antigen, and revealed the presence of autoantibodies in the serum (Figure 3B).