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Mucous membrane pemphigoid (MMP) is a rare mucosal-dominant subepidermal autoimmune bullous disease, characterized by autoantibodies targeting different basement membrane zone (BMZ) molecules, including collagen XVII (BP180), laminin 332 and collagen VII.[1] A limited number of studies suggested 4 integrin as a relevant autoantigen of MMP,[[2], [4], [6]] especially of ocular MMP, but the prevalence of these autoantibodies in MMP remains elusive.[[1], [7]] Although searching for anti- 4 integrin antibodies is not yet recommended for the diagnosis of MMP, current guidelines strongly advice more investigations to clarify this issue.[9] In this 3-year monocentric retrospective study started in January 2018 (Ethical approval CEAVC 21730), we retrieved serum samples from 40 patients who were diagnosed with MMP, according to current guidelines.[9] Anamnestic, clinical and immunopathological features of patients are reported in Table 1. Representative images from two patients positive for anti- 4 integrin antibodies as well as one patient and a healthy control negative for anti- 4 integrin antibodies were shown. Unexpectedly, among the six patients, whose sera reacted with 4 integrin proteins, four patients exclusively showed oral disease, while two patients were multisite MMP including ocular involvement. [Extracted from the article]