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Pathology
A 65-year-old man has developed pruritus followed by blistering skin lesions over the trunk, legs, and arms over the past month. On physical examination, there are 1- to 4-cm tense bullae, particularly over flexural surfaces of the skin. A biopsy of one lesion is examined microscopically by direct immunofluorescence staining and shows a subepidermal bulla, with both IgG and C3 deposited linearly along the dermal-epidermal junction. He is treated with topical corticosteroids, and a month later the lesions are healed without scarring. Which of the following components of the skin has most likely been targeted by an autoantibody in this man?
Hemidesmosome
Keratinocyte cell membrane
Lamina densa
Nucleus
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