case_images: PMC9632984_01
case_images: The clinical, histological, and serological features of the patient. (A) Single buccal erosion with a sharp border. (B) Erosion on the penis with a sharp border. (C) Acneiform eruption with sterile pustules. (D) Biopsy from the oral ulceration with a massive infiltration of neutrophils, lymphocytes, and plasma cells (H&E 10x). (E) Negative direct immunofluorescence (DIF) on a biopsy from the oral mucosa. (F) Negative indirect immunofluorescence (IIF) on monkey esophagus.
case_images: fmed-09-1001120-g001.jpg
case_images: PMC9632984_01_fmed-09-1001120-g001.jpg
case_images: F1
case_images: A 36-year-old Caucasian male was admitted to our department because of recurrent oral and genital ulcerations (Figures 1A,B). Furthermore, he showed an acneiform eruption on his back that was recalcitrant to topical and systemic therapy with erythromycin (Figure 1C). A punch biopsy from oral ulceration showed a massive infiltration of neutrophils, lymphocytes, and plasma cells (Figure 1D). DIF on perilesional oral mucosa did not show any deposition of IgG or C3 (Figure 1E). Furthermore, indirect IF (IIF) on the monkey esophagus did not show IgG deposition (Figure 1F). To confirm our serological findings, we performed Western blotting that detected a reactivity against both intracellular and extracellular BP180 subdomains (Supplementary Figure 1).