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Journal of the American Academy of Dermatology
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le vendredi 7 février 2020
Doi : 10.1016/j.jaad.2019.11.059
accepted : 25 November 2019
IgA pemphigus: A systematic review
 

Khalaf Kridin, MD, PhD a, Payal M. Patel, MD b, Virginia A. Jones, MS b, Adriana Cordova, MS b, Kyle T. Amber, MD b,
a Department of Dermatology, Rambam Health Care Campus, Haifa, Israel 
b Department of Dermatology, University of Illinois at Chicago, Chicago, Illinois 

Correspondence to: Kyle T. Amber, MD, Department of Dermatology, University of Illinois at Chicago, 808 S Wood St, RM377, Chicago, IL 60612.Department of DermatologyUniversity of Illinois at Chicago808 S Wood St, RM377ChicagoIL60612
Abstract
Background

The clinical, histologic, and immunopathologic features of IgA pemphigus have not been studied on a large scale.

Objective

To synthesize existing data on the epidemiologic, clinical, histologic, and immunologic features of IgA pemphigus.

Methods

We performed a systematic review using MEDLINE, Embase, and Web of Science databases. Case reports and series of patients with IgA pemphigus were included.

Results

A total of 119 eligible studies, comprising 137 patients with IgA pemphigus with a mean age of 51.5 ± 21.0 years, were included. Most patients presented with vesicles (80.8%), pustules (75.0%), and circinate plaques (63.6%). Pruritus was present in 65.6% of reported patients. Intercellular deposition of IgA was noted in almost all patients (97.0%), and the remaining 3.0% of patients had IgA positivity on indirect immunofluorescence or enzyme-linked immunosorbent assay confirming the diagnosis. IgA circulating intercellular antibodies were detected in only 66.7% patients. IgA gammopathy and ulcerative colitis were associated with IgA pemphigus in 9.5% and 6.6% patients, respectively. Oral dapsone and corticosteroids were the mostly commonly used treatments.

Limitations

Results are mainly based on case reports and small case series.

Conclusions

The diagnosis of IgA pemphigus may be considered in patients presenting with vesiculopustular eruption and circinate plaques with truncal and extremity involvement.

The full text of this article is available in PDF format.

Key words : immunoreactivity, IgA pemphigus, systematic review

Abbreviations used : AIBD, DIV, ELISA, IEN, IIF, PF, PV, SPD



 Drs Kridin and Patel are cofirst authors.
 Funding sources: None.
 Conflicts of interest: None disclosed.
 IRB approval status: The IRB has exempted this study from review.
 Reprints not available from the authors.



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