PMC5346946_01
a-c Widespread tense blisters and erosions on his skin, especially on the scalp, arms, and legs, as well as erythrodermic ichthyosiform scaly skin due to ichthyosis vulgaris.
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f1
A 25-year-old man was referred to the outpatient clinic's Bullous Disease Unit, at the Department of Dermatology and Venereology of Akdeniz University, with a 3-year history of widespread tense blisters and erosions on his skin and mucous membranes (Fig. 1a-c).
a Subepidermal bullae and a mixed infiltrate with eosinophils. b Direct immunofluorescence shows linear IgG and complement 3 deposition in the BMZ.
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f2
The diagnosis of BP was based on histologic findings showing subepidermal bullae and a mixed infiltrate with eosinophils (Fig. 2a), direct immunofluorescence on basal membrane zone (BMZ) showing linear IgG and complement 3 deposition, serum indirect immunofluorescence (IIF) revealing an IgG-circulating anti-BMZ antibody (BP180 and BP230) (Fig. 2b), serum IIF on salt-split, human skin substrate labeling the epidermal roof of the salt-split skin, and enzyme-linked immunosorbent assay (ELISA) showing that his serum anti-BMZ autoantibody recognized BP180 (>200 U), but not desmogleins.
a-d Complete resolution of blisters was observed.
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f3
He has been maintaining his state of complete remission off therapy for 12 months (Fig. 3a-d).