Anti-LPP monoclonal antibody, clone 9C4B22

Lichen planus pemphigoides (LPP) is an immunobullous disorder characterized by a combination of lesions resembling bullous pemphigoid and lichen planus (LP). Immunofluorescence studies typically show linear deposition of IgG and C3 along the basement membrane zone and circulating antibodies to the hemidesmosome protein BP180 also known as type XVII collagen. It is now recognized that drug-induced linear IgA disease may present with lesions mimicking toxic epidermal necrolysis (TEN). However, to date, there have been no reported cases of LPP presenting with TEN-like lesions. This report describes a 70-year-old woman with LPP who presented with extensive erosions mimicking TEN. This case also highlights the need to consider important etiologies such as drug-induced and paraneoplastic LPP.

Previous neurophysiological research suggests that there are event-related potential (ERP) components associated with empathy for pain: an early affective component (N2) and two late cognitive components (P3/LPP). The current study investigated whether and how the visual perspective from which a painful event is observed affects these ERP components. Participants viewed images of hands in pain vs. not in pain from a first-person or third-person perspective. We found that visual perspective influences both the early and late components. In the early component (N2), there was a larger mean amplitude during observation of pain vs no-pain exclusively when images were shown from a first-person perspective. We suggest that this effect may be driven by misattributing the on-screen hand to oneself. For the late component (P3), we found a larger effect of pain on mean amplitudes in response to third-person relative to first-person images. We speculate that the P3 may reflect a later process that enables effective recognition of others? pain in the absence of misattribution. We discuss our results in relation to self- vs other-related processing by questioning whether these ERP components are truly indexing empathy (an other-directed process) or a simple misattribution of another?s pain as one?s own (a self-directed process).