Immunoglobulin Disorders and the Oral Cavity: A Narrative Review.

The oral mucosa is a mechanical barrier against the penetration and colonization of microorganisms. Oral homeostasis is maintained by congenital and adaptive systems in conjunction with normal oral flora and an intact oral mucosa. Components contributing to the defense of the oral cavity include the salivary glands, innate antimicrobial proteins of saliva, plasma proteins, circulating white blood cells, keratinocyte products of the oral mucosa, and gingival crevicular fluid. General disturbances in the level of immunoglobulins in the human body may be manifested as pathological lesions in the oral mucosa. Symptoms of immunoglobulin-related general diseases such as mucous membrane pemphigoid (MMP), pemphigus vulgaris (PV), linear IgA bullous dermatosis (LABD), Epidermolysis Bullosa Aquisita (EBA), and Hyper-IgE syndrome (HIES) may appear in the oral cavity. In this review, authors present selected diseases associated with immunoglobulins in which the lesions appear in the oral cavity. Early detection and treatment of autoimmune diseases, sometimes showing a severe evolution (e.g., PV), allow the control of their dissemination and involvement of skin or other body organs. Immunoglobulin disorders with oral manifestations are not common, but knowledge, differentiation and diagnosis are essential for proper treatment.

Linear Immunoglobulin a Bullous Dermatosis in Children.

Linear Immunoglobulin A Bullous Disease (LABD) is a rare dermatosis whose pathomechanisms are not yet completely understood. LABD has different features characterizing adults and children in terms of potential triggers, clinical manifestations, and prognosis. The aim of the present study is to review all neonatal and pediatric cases of LABD and summarize the major characteristics. Childhood LABD is mainly idiopathic with a benign prognosis. Neonatal cases are difficult to differentiate from infectious diseases and usually have a poor prognosis. Drugs are one of the possible triggers that can activate autoimmune responses through antigen mimicry and epitope spreading as well as different stimuli (e.g., infections, inflammatory diseases, trauma). The gold standard for the diagnosis is based on direct immunofluorescence. Prognosis is generally favorable but often depends on the prompt dermatological diagnosis, treatment and follow-up guaranteed by a multidisciplinary team, including pediatricians for this group of age.

A Case of Linear IgA Bullous Dermatosis Probably Caused by Captopril / 대한피부과학회지

Linear IgA bullous dermatosis (LABD) is a rare autoimmune subepidermal bullous disease characterized by a linear pattern of IgA deposition along the basement membrane zone. The etiology of LABD is unknown but a minority of cases are drug-induced. Although vancomycin is the agent most commonly implicated in the pathogenesis of drug-induced LABD, association with other agents including phenytoin, piroxicam, captopril, diclofenac sodium and cyclosporine have also been reported. We describe a case of linear IgA bullous dermatosis which probably developed after captopril treatment in a 51-year-old male patient with infective endocarditis.

A case of Linear IgA Bullous Dermatosis Probably Caused by Vancomycin / 대한피부과학회지

Linear IgA bullous dermatosis (LABD) is an uncommon acquired autoimmune subepidermal bullous disease characterized by the linear deposition of IgA at the basement membrane zone. Although LABD is most often idiopathic, drug-induced LABD may, occur in rare occasions. We report a case of vancomycin-induced LABD in a 70-year-old woman with septic arthritis on the right knee.