We present an 84-year-old Japanese male showing typical features of bullous pemphigoid (BP). However, immunofluorescence of normal human skin sections revealed concurrent anti-basement-membrane-zone and anti-keratinocyte-cell-surface autoantibodies in the serum. With immunoblotting, the patient's serum reacted with desmoplakins I and II, as well as with both the 230-kD and the 180-kD BP antigens. The studies for this case may provide us with an insight to understand the occurrence of antidesmoplakin antibodies in paraneoplastic pemphigus.
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Watanabe et al. (2009) studied this question.