Letters to the Editor
Serum thymus and activationregulated chemokine (TARC/ CCL17) levels reflect the disease activity in a patient with bullous pemphigoid Editor Bullous pemphigoid (BP) is an autoimmune blistering disease characterized by eosinophilia and high serum IgE levels. It is thought to be a Th2-dominant inflammatory skin disease. Thymus and activation-regulated chemokine (TARC)/CCL17 is a Th2 chemokine. We report a BP patient who showed high levels of serum TARC/CCL17 that correlated with the disease activity. A 66-year-old man presented with bullous eruptions on his palms. A month later, new blisters developed on nearly the whole body. He was initially given 0.25 mg/kg/day oral prednisone, increased to 0.5 mg/kg/day, in a dermatology clinic. However, the bullous lesions spread over the entire body, and he was referred to our hospital. On admission, he presented bullae and erythema on almost the whole body surface (Fig. 1a) without mucosal involvement. Skin biopsy showed subepidermal blisters with dermal inflammatory cell infiltration (Fig. 1b). Direct immunofluorescent examination showed the linear deposition of IgG and C3 along the basement membrane zone. Laboratory findings revealed a white blood cell count of 16 300/lL (normal range: 3800–8500), eosinophils of 3.0% (1.0–6.0), CRP of 3.52 mg/dL (
Serum thymus and activationregulated chemokine (TARC/ CCL17) levels reflect the disease activity in a patient with bullous pemphigoid Editor Bullous pemphigoid (BP) is an autoimmune blistering disease characterized by eosinophilia and high serum IgE levels. It is thought to be a Th2-dominant inflammatory skin disease. Thymus and activation-regulated chemokine (TARC)/CCL17 is a Th2 chemokine. We report a BP patient who showed high levels of serum TARC/CCL17 that correlated with the disease activity. A 66-year-old man presented with bullous eruptions on his palms. A month later, new blisters developed on nearly the whole body. He was initially given 0.25 mg/kg/day oral prednisone, increased to 0.5 mg/kg/day, in a dermatology clinic. However, the bullous lesions spread over the entire body, and he was referred to our hospital. On admission, he presented bullae and erythema on almost the whole body surface (Fig. 1a) without mucosal involvement. Skin biopsy showed subepidermal blisters with dermal inflammatory cell infiltration (Fig. 1b). Direct immunofluorescent examination showed the linear deposition of IgG and C3 along the basement membrane zone. Laboratory findings revealed a white blood cell count of 16 300/lL (normal range: 3800–8500), eosinophils of 3.0% (1.0–6.0), CRP of 3.52 mg/dL (
