You are called to evaluate a patient with a new onset vesicular eruption that developed 7 days after starting intravenous vancomycin.
At what level of the dermoepidermal junction is the target antigen found?
A). Lamina lucida
B.) Lamina densa
C.) Sublamina densa
D.) Basal keratinocyte
E.) Lamina reticularis
Correct Answer: A. Lamina lucida
Annular plaques with tense vesicles at the periphery (“string of pearls”) is typical of linear IgA bullous dermatosis. Antibodies are directed against the linear IgA disease antigen (LAD-1), 97-kDa portion of BPAG-2, which is localized to the lamina lucida.
Reference:
Ishiko A, Shimizu H, Masunaga T. 97 kDa linear IgA bullous dermatosis antigen localizes in the lamina lucida between the NC16A and carboxyl terminal domains of the 180 kDa
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