Bullous pemphigoid and milia: prevalence and clinical laboratory findings in a Brazilian sample

Author(s)

Vernal, Sebastian ; de Oliveira, Ederson Valei ; Bueno Filho, Roberto ; Julio, Tamiris A. ; Donadi, Eduardo A. ; Turatti, Aline ; Ishii, Norito ; Hashimoto, Takashi ; Roselino, Ana Maria

• Document type: Journal article
• Source: ANAIS BRASILEIROS DE DERMATOLOGIA; v. 97, n. 4, p. 8-pg., 2022-06-28.

Abstract

Background: Butlous pemphigoid (BP) associated with milia lesions has been increasingly reported, but its prevalence has not been reported in a Brazilian BP population yet. Objectives: To describe the occurrence and clinical-laboratorial findings of BP-milia association in a southeastern Brazilian sample. Methods: A descriptive study based on the medical charts of 102 BP patients was accomplished. Clinical and laboratory data of BP-milia patients were compiled. Total serum IgE measurements, immunoblot assays based on basement membrane zone antigens, and HLA-DQ alleles typing were performed. Results: Milia was evident in 8 (7.8%) BP patients, five males, aged between 46 and 88 years. Increased total IgE levels were determined in 7 (87.5%) of the eight patients. In five of eight patients, immunoblotting showed IgG reactivity against the BP180-NC16a domain but not against collagen VII or laminin-332; it also revealed reactivity against the BP180 C-terminal domain or LAD-1, or both in four of them. The HLA-DQB1*03:01 and HLA-DQA1*05:05 alleles were identified in three of five BP-milia patients. Moreover, three of five cases presented the HLA-DQB1*06 allelic group. Study limitations: HLA determination was performed in five patients. Conclusions: Milia formation in BP patients seems to be less uncommon than previously admitted. Laboratory data revealed increased IgE; autoantibodies against the BP180 C-terminal domain or LAD-1, or both; and the HLA-DQB1*06 allelic group, described for the BP-milia association. Careful determination of antibodies against basement membrane zone molecules and HLA characterization in different populations may provide further insights into this association. (C) 2022 Sociedade Brasileira de Dermatologia. Published by Elsevier Espana, S.L.U. (AU)

• FAPESP's process: 10/51729-2 - Relation between immunogenetics and environmental factors in a Brazilian epidemiological study of Pemphigus vulgaris and Pemphigus foliaceus
• Grantee: Ana Maria Ferreira Roselino
• Support Opportunities: Research Projects - Thematic Grants