Mixed bullous disease with labile erythrocyte sedimentation rate.
A woman, aged 66, fulfilled all the usual criteria of dermatitis herpetiformis. Subsequently, she developed circulating IgA and IgM basement membrane zone antibodies, a labile erythrocyte sedimentation rate (ESR), and the clinical picture changed to one of bullous pemphigoid. Her labile ESR was obviously caused by a factor related to the erythrocytes. Direct Coombs test was positive.
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