Linear IgA bullous dermatosis (LABD) is characterized by presence of multiple Warming Drawer IgA autoantibodies, and a comparatively lesser number of IgG antibodies, directed against different hemidesmosomal antigens.The main autoantigens are LAD-1, LABD-97, BP180 and BP230, type VII collagen and laminin 332.We retrospectively studied the serology of 54 Italian patients with LABD using enzyme-linked immunosorbent assay (ELISA), immunoblotting assay, and indirect immunofluorescence on monkey oesophagus and salt-split skin.Among these, indirect immunofluorescence of salt-split skin elicits the greatest sensitivity.
Sixty-three percent of the sera were observed to be positive, with a lamina lucida pattern observed in 48%, a sub-lamina densa pattern in 2% and a mixed pattern in 13% of the cases.IgA reactivity to LAD-1 on immunoblotting was found in 52% of sera, to BP180-NC16A by ELISA in 32% and to BP230 in 26%.Only 17% of patients possessed circulating IgG autoantibodies.LAD-1 was determined to be a major autoantigen of the lamina lucida subtype.
Combined serological assays demonstrated a high sensitivity (82%), suggesting that this approach could support diagnosis when a biopsy is not TIE-DYE Hoodie feasible or direct immunofluorescence results are negative.