Our patient was considered to have anti-laminin gamma-1 pemphigoid of vesicular pemphigoid type, which has been seen in 10% of patients. 1 Bullous disease in our patient might have been induced and aggravated by scabies for following reasons: (i) the scabietic lesion on the left scapular area already existed at the first visit; (ii) the patient originally showed eczematous lesions; and (iii) ivermectin suppressed both bul- lous and keratotic lesions. However, scabies infestation might have merely precipitated pre-existing bullous disease in our case, as was suggested to have occurred through metal allergy in a previous case. 3 There have been some bullous scabies cases with BP-like bullous lesions and positive direct immunofluorescence results. Therefore, if ELISA or immunoblotting were performed, inci- dence of autoimmune bullous diseases with scabies would become higher. We found only one case of true BP 2 and one case of true anti-laminin gamma-1 pemphigoid (Japanese pub- lished work). 4 Thus, our patient is the first case of anti-laminin gamma-1 pemphigoid with scabies in the English-language published work. Two mechanisms for production of BP autoantibodies in patients with scabies were speculated; 5 lytic secretion of sca- bies mites could injure BMZ and release skin antigens, and mites could cross-react with skin antigens. Our patient might support the former hypothesis. ACKNOWLEDGMENTS: We gratefully appreciate the secre- tarial work of Ms Tomoko Tashima. We thank the patient for his partici- pation. CONFLICT OF INTEREST: The authors have no conflict of interest. Shigeruko IIJIMA, 1 Yukiko OKAZAKI, 1 Shinya WATANABE, 1 Daisuke TSURUTA, 2 Chiharu TATEISHI, 2 Norito ISHII, 3 Chika OHATA, 3 Takashi HASHIMOTO 3 1 Department of Dermatology, Mito Saiseikai General Hospital, Ibaraki, 2 Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, and 3 Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Fukuoka, Japan doi: 10.1111/1346-8138.13020 REFERENCES 1 Dainichi T, Kurono S, Ohyama B et al. Anti-laminin gamma-1 pem- phigoid. Proc Natl Acad Sci U S A 2009; 106: 2800–2805. 2 Konishi N, Suzuki K, Tokura Y, Hashimoto T, Takigawa M. Bullous eruption associated with scabies: evidence for scabetic induction of true bullous pemphigoid. Acta Derm Venereol 2000; 80: 281– 283. 3 Baican A, Chiriac G, Baican C et al. Metal sensitization precipitates skin blistering in epidermolysis bullosa acquisita. J Dermatol 2010; 37: 280–282. 4 Ogata M, Misago N, Inoue T et al. A case of anti-p200 pemphigoid suspected of the relation of scabies. Nishinihon J Dermatol 2006; 68: 375–378. (in Japanese). 5 Ostlere LS, Harris D, Rustin MH. Scabies associated with a bullous pemphigoid-like eruption. Br J Dermatol 1993; 128: 217–219. Immediate allergy due to raw garlic (Allium sativum L.) Dear Editor, Garlic is used worldwide not only as a foodstuff but also as a seasoning agent and nutritional supplement. A 31-year-old housewife visited our clinic after two episodes of immediate hypersensitivity reactions after ingesting meals that included raw garlic. During the first episode, wheals appeared after she ingested raw, grated garlic along with meat and vegetables. In the second episode, wheals appeared after ingesting raw garlic and gochujang (Korean red chili paste). She had suffered from atopic dermatitis, but had no history of food allergy, and had no occupational exposure to garlic. Prick and scratch tests results were negative for gochujang and cooked garlic, whereas only edible raw garlic showed a positive reaction (6 mm 9 6 mm) with the scratch test. The wheal induced by 1% of histamine dihydrochloride (Wako Pure Chemical Industries, Osaka, Japan) as the positive control with the scratch test was 5 mm 9 5 mm. Scratch tests performed on three controls using raw garlic were all negative and the gochujang brought in by the patient did not contain any garlic. We performed skin-prick testing using cooked beef, cooked pork and raw Japanese radish. She showed negative reactions for these foodstuffs. We obtained an extract by adding 1 mL of distilled water to grated garlic and filtering it through gauze. We performed sodium dodecylsulfate polyacrylamide gel electrophoresis with the extract of raw garlic and transferred it to nitrocellulose membrane by diffusion; sera from both the patient and the six controls were added and incubated. In immunoblotting assay, we identified a protein band in the 75-kDa region (Fig. 1; lanes 4, 5 and 8). The immunoglobulin (Ig)E-binding protein band was almost undetectable when using control sera (lanes 3 and 7). On the inhibition immuno- blotting assay using the extract without 2-mercaptoethanol, the IgE-binding signal of the protein band in the 75-kDa region dis- appeared (Fig. 1; lane 9). From these results, we considered that the protein band in the 75-kDa region was one of the causative antigens in garlic allergy. We plan to carry out immu- noblotting assay and enzyme-linked immunoassay using the cooked (heated) garlic in future. Correspondence: Akiko Yagami, M.D., Ph.D., Department of Dermatology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukakecho Toyoake, Aichi 470-1192, Japan. Email: ayagami@fujita-hu.ac.jp 1026 © 2015 Japanese Dermatological Association Letters to the Editor