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Updated: May 27, 2026

Granulocyte-dependent Autoantibody-induced Skin Blistering

Granulocyte-dependent Autoantibody-induced Skin Blistering

Published on: October 12, 2012

[Anti-p200 pemphigoid: a spectacular response to dapsone].

C Munsch¹, S Prey, P Joly

¹Service de dermatologie et université Paul-Sabatier, CHU Toulouse, hôpital Larrey, TSA30030, 31059 Toulouse cedex 9, France. coline-danse@voila.fr

Annales De Dermatologie Et De Venereologie

|November 15, 2011

Summary

Anti-p200 pemphigoid is a newly identified autoimmune blistering disease. Diagnosis can be challenging, but dapsone is an effective treatment for this condition.

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Last Updated: May 27, 2026

Granulocyte-dependent Autoantibody-induced Skin Blistering

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Technique of Conjunctival Biopsy and Direct Immunofluorescence for Diagnosing Mucous Membrane Pemphigoid

Technique of Conjunctival Biopsy and Direct Immunofluorescence for Diagnosing Mucous Membrane Pemphigoid

Published on: June 17, 2025

Area of Science:

Dermatology
Immunology
Autoimmune diseases

Background:

Subepidermal autoimmune bullous dermatoses (AIBD) are classified by clinical presentation and target antigen.
A novel AIBD entity, anti-p200 pemphigoid, has been recently identified.

Observation:

A patient presented with a severe, treatment-refractory bullous eruption.
Standard bullous pemphigoid (BP) antibody testing was negative.
Immunofluorescence showed IgG and C3 deposition at the dermal-epidermal junction, with IgG4 on the dermal side.
Immunoblotting detected antibodies against a 200-kD epidermal antigen.

Findings:

Diagnosis of anti-p200 pemphigoid was established despite atypical immunofluorescence and immunoblotting results.
Anti-p200 pemphigoid autoantibodies target laminin gamma-1, an extracellular matrix protein crucial for dermal-epidermal adhesion.
This condition is more prevalent in males, often presents in later life, and may involve mucous membranes and the head, with a higher incidence of scarring compared to BP.
A significant association with psoriasis is noted in about one-third of cases.

Implications:

Anti-p200 pemphigoid may be underdiagnosed, particularly in France.
Consideration of anti-p200 pemphigoid is crucial for atypical bullous disease presentations.
Immunoblotting for a 200-kD antigen confirms diagnosis.
Dapsone demonstrates efficacy as a primary treatment modality.