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Linear IgA disease histopathologically and clinically masquerading as lichen planus.
D M Cohen1, I Bhattacharyya, S L Zunt
1Department of Oral Biology, College of Dentistry, University of Nebraska Medical Center, Lincoln 68583, USA.
Summary
Linear IgA disease can mimic oral lichen planus, especially with blistering. Direct immunofluorescence is crucial for accurate diagnosis of these recalcitrant conditions.
Area of Science:
- Dermatology
- Oral Medicine
Background:
- Oral lichen planus and lichenoid drug eruptions are common conditions.
- Accurate diagnosis is essential for effective treatment.
Observation:
- Two cases presented with features mimicking erosive lichen planus or lichenoid drug eruptions.
- Biopsies initially diagnosed lichen planus, but recurrences showed vesiculobullous lesions.
Findings:
- Direct immunofluorescence revealed linear IgA disease in both cases.
- Patients responded well to dapsone after limited success with corticosteroids and sulfapyridine.
Implications:
- Linear IgA disease may be underdiagnosed in oral conditions resembling lichen planus.
- Direct immunofluorescence is recommended for suspected bullous lichen planus to identify linear IgA disease.