Usefulness of Enzyme-linked Immunosorbent Assay Using Recombinant BP180 and BP230 for Serodiagnosis and Monitoring Disease Activity of Bullous Pemphigoid

BACKGROUND: Bullous pemphigoid (BP) is an autoimmune subepidermal bullous disease associated with autoantibodies against BP180 and BP230. Enzyme-linked immunosorbent assay (ELISA) is a sensitive tool for the detection of immunoglobulin G (IgG) anti-BP180 and anti-BP230 autoantibodies. OBJECTIVE: The aim of this study was to evaluate the usefulness of ELISA for diagnosing and monitoring the disease activity of BP. METHODS: We evaluated serum IgG levels of anti-BP180 and anti-BP230 autoantibodies in 47 BP patients, 16 epidermolysis bullosa aquisita patients, and 15 healthy volunteers using ELISA. Through retrospective review of the medical records, the clinical characteristics of BP including disease activity, duration, pruritus severity and peripheral blood eosinophil counts were assessed. RESULTS: The sensitivity of BP180 ELISA was 97.9%, BP230 ELISA 72.3%, and a combination of the two was 100%. The specificity of BP180 ELISA was 90.3%, BP230 ELISA 100%, and a combination of the two was 90.3%. BP180 ELISA scores showed strong associations with disease activity, pruritus severity, peripheral blood eosinophil counts, and disease duration, whereas BP230 ELISA scores did not. CONCLUSION: BP180 and BP230 ELISAs are highly sensitive methods for the diagnosis of BP, and BP180 ELISA, in particular, is a sensitive tool for monitoring the disease activity of BP.

Diffuse Cutaneous Mastocytosis with Generalized Bullae

We report on a 9-month-old female infant with multiple tense bullae and erosions covering the entire body, including the face, scalp, and trunk. The histopathological examination revealed sub-epidermal bullae with a dense dermal cellular infiltrate. The infiltrate was identified as a collection of mast cells using toluidine blue and Giemsa stains. The direct immunofluorscence was negative. A diagnosis of cutaneous diffuse mastocytosis with generalized bullae was made based on these clinical and histopathological findings. In cases with diffuse cutaneous mastocytosis with generalized bullae, systemic involvement is more frequent and more severe compared to other types of cutaneous mastocytosis. Some lethal outcomes have been reported. This is the first reported case of diffuse cutaneous mastocytosis in the Korean literature.

A Case of Psoriasis with a Chronic Oral Ulcer / 대한피부과학회지

Psoriasis is a chronic inflammatory disease with epidermal hyperplasia. Th 1 cells are thought to be important in the pathogenesis of psoriasis and Behcet's disease. However, both diseases rarely develop in the same patient. We report here a case of a 50-year-old man who was diagnosed with psoriasis 15 years prior. During the last three years, ulcers and erosions had recurrently developed on the perianal area and oral mucosa. In addition, the patient had mild arthralgia on the both knees and hand for two years. In this case, Behcet's disease accompanying psoriasis was suspected.

A Case of Ingrown Toenails Treated by the Super Elastic Wire Insertion Method / 대한피부과학회지

An ingrown toenail, which causes pain especially with secondary infection, and is one of the most common diseases of toenails. It becomes difficult for a patient to walk and this subsequently impairs the quality of life. Surgical procedures, including total or partial excision of the nail bed, phenolization and the carbon dioxide laser matricectomy method, are commonly performed to treat this problem. The disadvantages of these methods include their complexity, the pain, the time required to do the procedure and the need for local anesthesia during the operation. We present here successful therapy for a patient with ingrown nails with using a super elastic wire (SE-wire, Machiwire(R)). To the best of our our knowledge, this is the first case that describes the clinical benefits of the SE-wire for the treatment of ingrown nails in a Korean patient.

A Case of Ingrown Toenails Treated by the Super Elastic Wire Insertion Method / 대한피부과학회지

An ingrown toenail, which causes pain especially with secondary infection, and is one of the most common diseases of toenails. It becomes difficult for a patient to walk and this subsequently impairs the quality of life. Surgical procedures, including total or partial excision of the nail bed, phenolization and the carbon dioxide laser matricectomy method, are commonly performed to treat this problem. The disadvantages of these methods include their complexity, the pain, the time required to do the procedure and the need for local anesthesia during the operation. We present here successful therapy for a patient with ingrown nails with using a super elastic wire (SE-wire, Machiwire(R)). To the best of our our knowledge, this is the first case that describes the clinical benefits of the SE-wire for the treatment of ingrown nails in a Korean patient.