{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T05:30:29Z","timestamp":1762061429551,"version":"build-2065373602"},"reference-count":7,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T00:00:00Z","timestamp":1659916800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dermatopathology"],"abstract":"<jats:p>A 76-year-old Japanese man presented with a 6-year history of a sore throat. He was treated at several clinics without any improvement before being referred to us. Physical examination revealed widespread erosions and ulcers from the palate to the larynx. Approximately 25 \u00d7 15 mm in size, erosive lesions were present on the retroauricular regions, forearms, and glans penis. Pseudomembranous conjunctivitis was also observed. The skin biopsy revealed a partial cleft formation below the epidermis, suggesting subepidermal bullous disease. Immuno-serological tests were negative for anti-desmoglein 1 (Dsg1), anti-Dsg3, anti-BP180, and anti-BP230 antibodies by ELISAs. A whole-body examination revealed gastric cancer. The possibility of mucous membrane pemphigoid (MMP) or paraneoplastic pemphigus (PNP) was considered. Indirect immunofluorescence using rat bladders showed positive IgG reactivity with cell surfaces on the transitional epithelia. Immunoblotting using recombinant proteins of laminin-332 showed both IgG and IgA reactivities with laminin-\u03b13, and immunoblotting using normal human epidermal extract showed double-positive reactivities with envoplakin and periplakin for both IgG and IgA antibodies. Based on the clinical and histopathological features and results of various immuno-serological tests, our case was diagnosed as anti-laminin-332-type MMP with serological findings of PNP. Twenty days after laparoscopic gastrectomy, treatment with oral methylprednisolone 32 mg\/day was initiated, and mucosal and skin lesions improved.<\/jats:p>","DOI":"10.3390\/dermatopathology9030034","type":"journal-article","created":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T21:09:18Z","timestamp":1659992958000},"page":"287-291","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A Case of IgG and IgA Anti-Laminin-332 Antibody-Positive Mucous Membrane Pemphigoid with IgG and IgA Anti-Envoplakin and Anti-Periplakin Antibodies"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6114-0830","authenticated-orcid":false,"given":"Yoshiaki","family":"Matsushima","sequence":"first","affiliation":[{"name":"Department of Dermatology, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masako","family":"Kitano","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2014Head & Neck Surgery, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daisuke","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Graduate School of Medicine, Osaka Metropolitan University, Osaka 545-8585, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7008-4527","authenticated-orcid":false,"given":"Hiroyuki","family":"Goto","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mako","family":"Mine","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Graduate School of Medicine, Osaka Metropolitan University, Osaka 545-8585, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Yokoe","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal and Pediatric Surgery, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1560-6067","authenticated-orcid":false,"given":"Makoto","family":"Kondo","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koji","family":"Habe","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuji","family":"Toiyama","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal and Pediatric Surgery, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Graduate School of Medicine, Osaka Metropolitan University, Osaka 545-8585, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6283-0251","authenticated-orcid":false,"given":"Daisuke","family":"Tsuruta","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Graduate School of Medicine, Osaka Metropolitan University, Osaka 545-8585, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuhiko","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2014Head & Neck Surgery, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3055-5202","authenticated-orcid":false,"given":"Keiichi","family":"Yamanaka","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1111\/bjd.17202","article-title":"A sensitive and specific assay for the serological diagnosis of antilaminin 332 mucous membrane pemphigoid","volume":"180","author":"Goletz","year":"2019","journal-title":"Br. J. Dermatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/j.oooo.2013.12.402","article-title":"Diagnosis of oral mucous membrane pemphigoid by means of combined serologic testing","volume":"117","author":"Hayakawa","year":"2014","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1111\/bjd.20099","article-title":"Clinical and immunological findings in 55 patients with anti-laminin 332-type mucous membrane pemphigoid","volume":"185","author":"Li","year":"2021","journal-title":"Br. J. Dermatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1111\/bjd.14692","article-title":"Summary of results of serological tests and diagnoses for 4774 cases of various autoimmune bullous diseases consulted to Kurume University","volume":"175","author":"Hashimoto","year":"2016","journal-title":"Br. J. 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