A case of anti-BP180-type mucous membrane pemphigoid

We report a 65-year-old female patient with anti-BP180-type mucous membrane pemphigoid. Blisters appeared on her limbs, followed by erosion in the oral cavity. Histological examination of the blisters on her hand revealed spongiosis in the epidermis and subepidermal blisters. Direct immunouorescence revealed linear IgG and IgA deposition in the epidermal basement membrane. Serological tests for anti-BP180, anti-BP230, anti-desmoglein (Dsg) 3, and anti-Dsg1 antibodies were all negative. Immunoblotting detected an IgG antibody against a recombinant BP180 C-terminal protein. Tests for epidermal extract, dermal extract, the BP180-NC16a recombinant protein, and laminin 332 recombinant protein were negative. Based on these results, the patient was diagnosed with anti-BP180 mucous membrane pemphigoid. Mucous membrane pemphigoid exhibits several clinical symptoms and varies in severity depending on the target antigen. When blisters are localized in the oral cavity or are widespread, many cases are often diagnosed and treated as other diseases. As it is important to identify mucous membrane pemphigoid, its method of diagnosis requires improvement.