Successful treatment of oral linear IgA disease using mycophenolate

• Published in: Oral surgery, oral medicine, oral pathology, oral radiology and endodontics Vol. 103; no. 4; pp. 483 - 486
• Main Authors: Lewis, M.A.O., PhD, FDSRCPS, FDSRCS, FRCPath, Yaqoob, N.A., BDS, MFDS RCS(Eng), BSc, Emanuel, C., BDS, MFDS RCS(Eng), Potts, A.J.C., BSc, BDS, FRCPath
• Format: Journal Article
• Language: English
• Published: St. Louis, MO Mosby, Inc 01-04-2007; Elsevier
• Subjects: Aged; Anti-Inflammatory Agents - therapeutic use; Azathioprine - adverse effects; Biological and medical sciences; Bullous diseases of the skin; Dermatology; Diagnosis, Differential; Female; Fluorescent Antibody Technique; Fluorescent Antibody Technique, Direct; Gingival Diseases - diagnosis; Gingival Diseases - drug therapy; Gingival Diseases - immunology; Humans; Immunoglobulin A - analysis; Immunosuppressive Agents - therapeutic use; Medical sciences; Mycophenolic Acid - analogs & derivatives; Mycophenolic Acid - therapeutic use; Oral Ulcer - diagnosis; Oral Ulcer - drug therapy; Oral Ulcer - immunology; Otorhinolaryngology. Stomatology; Prednisolone - therapeutic use; Skin Diseases, Vesiculobullous - diagnosis; Skin Diseases, Vesiculobullous - drug therapy; Skin Diseases, Vesiculobullous - immunology; Surgery; Bullous dermatosis; Immunomodulator; Immunopathology; Skin disease; Mycophenolic acid; Treatment; Autoimmune disease; Oral cavity disease; Immunosuppressive agent; Linear IgA disease
• ISSN: 1079-2104; 1528-395X
• DOI: 10.1016/j.tripleo.2006.09.019

Linear IgA disease (LAD) is a rare acquired autoimmune bullous disorder, characterized by linear deposition of IgA along the dermoepidermal basement membrane zone. The clinical presentation of LAD consists of vesiculobullous lesions affecting the skin and mucosal surfaces. The present case report presents a rare presentation of this vesiculobullous disorder. Although more than 50% of LAD patients present with oral lesions, there are few reported cases of involvement of the mouth as the sole manifestation. A 79-year-old female presented with a sore mouth and erosions affecting the palate. The symptoms resolved following the provision of mycophenolate, an antiproliferative immunosuppressant which has not previously appeared to have been reported in the long-term successful management of linear IgA disease limited to the mouth. We found that mycophenolate is a useful adjunct to the successful treatment of oral linear IgA when the uses of other immunosuppressants are contraindicated.