The occurrence of IgA pemphigus foliaceus without neutrophilic infiltration

A 70-year-old woman with pemphigus foliaceus is reported. Direct immunofluorescence performed on perilesional skin revealed deposits of IgA, C3 and lambda chains in the intercellular substance of the upper stratum spinosum. Indirect immunofluorescence demonstrated serum antibodies of the IgA class against the intercellular region of the upper epidermis at an initial titre of 1:2560. Histological studies, performed together with immunofluorescence, revealed an absence of a distinct neutrophil infiltrate either in the epidermis or dermis, contrary to the findings in cases with intra-epidermal IgA deposits reported previously.