Granular deposit of IgA at dermoepidermal junction is seen in –
**Core Concept**
In dermatology, the deposition of immune complexes at the dermoepidermal junction is a critical factor in the pathogenesis of various autoimmune bullous diseases. The presence and type of immunoglobulins deposited at this site can help differentiate between these conditions.
**Why the Correct Answer is Right**
Dermatitis herpetiformis is a chronic skin condition characterized by granular deposits of IgA at the dermoepidermal junction. This deposition leads to the formation of subepidermal blisters, which are a hallmark of the disease. The exact mechanism of IgA deposition is not fully understood, but it is believed to be related to the presence of gluten-sensitive enteropathy. The IgA deposits in dermatitis herpetiformis are typically found in a granular pattern, in contrast to the linear deposition seen in bullous pemphigoid.
**Why Each Wrong Option is Incorrect**
**Option A:** Pemphigus vulgaris is characterized by the deposition of IgG antibodies against desmoglein 3 proteins, leading to suprabasal blistering. This is in contrast to the granular IgA deposits seen in dermatitis herpetiformis.
**Option B:** Bullous pemphigoid is characterized by linear deposition of IgG and C3 at the dermoepidermal junction, typically in a band-like pattern. This is distinct from the granular IgA deposits seen in dermatitis herpetiformis.
**Option D:** Pemphigus foliaceus is characterized by the deposition of IgG antibodies against desmoglein 1 proteins, leading to superficial blistering. This is in contrast to the granular IgA deposits seen in dermatitis herpetiformis.
**Clinical Pearl / High-Yield Fact**
Dermatitis herpetiformis is often associated with gluten-sensitive enteropathy, and treatment with a gluten-free diet can lead to significant improvement in symptoms. This is an important clinical correlation to remember when diagnosing and managing patients with this condition.
**β Correct Answer: C. Dermatitis herpatiformis**