Autoimmune subepidermal bullous disease with linear deposits of IgA and IgG

A 29-year-old female patient with an autoimmune subepidermal blistering dis ease had linear deposits of both IgA and IgG at the basement membrane zone. Clinically, the patient presented with tense blisters on the face, trunk, extremities and oral mucosa. Histologically, we found a subepidermal bliste r formation and a predominantly neutrophilic infiltrate. Direct immunofluor escence showed linear deposits of IgA along the basement membrane zone, as well as linear deposits of IgG and C3 as typically found in bullous pemphig oid. Indirect immunofluorescence demonstrated circulating IgA and IgG auto- antibodies. This case extends previous reports on a subgroup of patients wi th subepidermal blistering diseases characterized by the presence of both I gA and IgG anti-basement membrane antibodies. These patients reveal clinica l, histological and immunopathological features of linear IgA disease and b ullous pemphigoid.