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

• DOI: 10.1016/j.abd.2021.10.003
• Publication Date: 2022-05-27T13:14:28Z
• Authors: Sebastián Vernal; Ederson Valei de ...; Roberto Bueno Filho; Tamiris A. Julio; Eduardo A. Donadi; Aline Turatti; Norito Ishii; Takashi Hashimoto; Ana Maria Roselino
• Keywords: Aged, 80 and over; Male; Keratosis; Immunoglobulin E; Middle Aged; Non-Fibrillar Collagens; Autoantigens; 3. Good health; 230 kDa protein; 03 medical and health sciences; 0302 clinical medicine; Hemidesmosomal plaque protein; Pemphigoid, Bullous; Prevalence; Humans; Original Article; HLA antigens; Brazil; Laboratories, Clinical; Pemphigoid, bullous; Aged; Autoantibodies

Bullous pemphigoid (BP) associated with milia lesions has been increasingly reported, but its prevalence has not been reported in a Brazilian BP population yet.To describe the occurrence and clinical-laboratorial findings of BP-milia association in a southeastern Brazilian sample.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.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.HLA determination was performed in five patients.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.