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Localization of bullous pemphigoid antibody—an indirect immunofluorescence study of 228 cases using a split‐skin technique
Author(s) -
LOGAN R.A.,
BHOGAL B.,
DAS A.K.,
McKEE P.M.,
BLACK M.M.
Publication year - 1987
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/j.1365-2133.1987.tb04927.x
Subject(s) - epidermolysis bullosa acquisita , bullous pemphigoid , immunofluorescence , direct fluorescent antibody , lamina lucida , basement membrane , basal lamina , pemphigoid , pathology , medicine , antibody , dermatology , basal (medicine) , ultrastructure , immunology , endocrinology , diabetes mellitus
SUMMARY We have re‐examined the site of deposition of IgG anti‐basement membrane zone antibodies in 228 sera from suspected cases of bullous pemphigoid (BP), using I‐o M sodium chloride split‐skin as substrate for indirect immunofluorescence. Nine sera (4%) produced fluorescence on the floor of the split suggesting sub‐basal lamina antibody deposition compatible with a diagnosis of epidermolysis bullosa acquisita (EBA). This ultrastructurat localization was confirmed in only three of these nine by immuno‐electron microscopy. Clinical details were available on six of these nine cases, and none had clinical features suggesting EBA. We have found the split‐skin immunofluorescence technique unhelpful in identifying ‘missed’ cases of EBA. The prevalence of EBA presenting as BP would appear to be very low indeed in the U.K.