Bullous pemphigoid exacerbation associated with reactivation of herpes simplex virus infection
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pemphigoid exacerbation associated with reactivation of herpes simplex virus infection Here, we report a case of bullous pemphigoid (BP) complicated by reactivation of herpes simplex (HSV) infection with immunological analyses. An 87-year-old Japanese woman presented with a twomonth history of bullous skin lesions. A physical examination revealed tense bullae and erosions on the back and extremities without mucous membrane lesions (figure 1A). Histopathology of a bulla showed a basal vacuolar change and a subepidermal bulla containing eosinophils (figure 1B). Direct immunofluorescence (IF) showed linear deposition of C3 along the basement membrane zone (BMZ) (figure 1C). Indirect IF of normal human skin revealed circulating IgG anti-BMZ antibodies, which reacted with the epidermal side of 1M NaCl-split skin (figure 1D). Chemiluminescence enzyme immunoasEJD, vol. 30, n◦ 4, July-August 2020
say (CLEIA) detected anti-BP180 autoantibodies at very low titre (10.5 U/mL; normal
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