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Repeat Direct Immunofluorescence to Discriminate Pemphigoid From Epidermolysis Bullosa Acquisita

Repeat Direct Immunofluorescence to Discriminate Pemphigoid From Epidermolysis Bullosa Acquisita Abstract To the Editor.— A recent publication by Zhu and coworkers1 examined antibody-positive serum samples from 100 sequential patients on sodium chloride-split skin and by Western immunoblot to distinguish bullous pemphigoid from epidermolysis bullosa acquisita. Five percent of unselected patients were shown to have epidermolysis bullosa acquisita.An editorial in the same issue of the Archives2 brings the problem of such studies into focus. Less than 50% of patients with epidermolysis bullosa acquisita or bullous pemphigoid have free, circulating antibodies capable of reacting with normal salt-split skin. Thus, a determination by indirect immunofluorescence can only be ascertained in less than half of such individuals. The editorial cites an article by Gammon et al3 that showed direct immunofluorescence on perilesional skin incubated in 1 mol/L of sodium chloride induces a separation at the dermoepidermal junction through the lamina lucida. This allowed detection of complement or antibody to (1) epidermis alone References 1. Zhu XJ, Niimi Y, Bystryn JC. Epidermolysis bullosa acquisita . Arch Dermatol. 1990;126:171-174.Crossref 2. Woodley DT. Immunofluorescence on salt-split skin for the diagnosis of epidermolysis bullosa acquisita . Arch Dermatol. 1990;126:229-231.Crossref 3. Gammon WR, Kowalewski C, Chorzelski TP, Kumar V, Briggaman RA, Buetner EH. Direct immunofluorescence studies of sodium chloride-separated skin in the differential diagnosis of bullous pemphigoid and epidermolysis bullosa acquisita . J Am Acad Dermatol. 1990;22:664-670.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Repeat Direct Immunofluorescence to Discriminate Pemphigoid From Epidermolysis Bullosa Acquisita

Archives of Dermatology , Volume 126 (10) – Oct 1, 1990

Repeat Direct Immunofluorescence to Discriminate Pemphigoid From Epidermolysis Bullosa Acquisita

Abstract

Abstract To the Editor.— A recent publication by Zhu and coworkers1 examined antibody-positive serum samples from 100 sequential patients on sodium chloride-split skin and by Western immunoblot to distinguish bullous pemphigoid from epidermolysis bullosa acquisita. Five percent of unselected patients were shown to have epidermolysis bullosa acquisita.An editorial in the same issue of the Archives2 brings the problem of such studies into focus. Less than 50% of patients with...
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References (5)

Publisher
American Medical Association
Copyright
Copyright © 1990 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1990.01670340117021
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor.— A recent publication by Zhu and coworkers1 examined antibody-positive serum samples from 100 sequential patients on sodium chloride-split skin and by Western immunoblot to distinguish bullous pemphigoid from epidermolysis bullosa acquisita. Five percent of unselected patients were shown to have epidermolysis bullosa acquisita.An editorial in the same issue of the Archives2 brings the problem of such studies into focus. Less than 50% of patients with epidermolysis bullosa acquisita or bullous pemphigoid have free, circulating antibodies capable of reacting with normal salt-split skin. Thus, a determination by indirect immunofluorescence can only be ascertained in less than half of such individuals. The editorial cites an article by Gammon et al3 that showed direct immunofluorescence on perilesional skin incubated in 1 mol/L of sodium chloride induces a separation at the dermoepidermal junction through the lamina lucida. This allowed detection of complement or antibody to (1) epidermis alone References 1. Zhu XJ, Niimi Y, Bystryn JC. Epidermolysis bullosa acquisita . Arch Dermatol. 1990;126:171-174.Crossref 2. Woodley DT. Immunofluorescence on salt-split skin for the diagnosis of epidermolysis bullosa acquisita . Arch Dermatol. 1990;126:229-231.Crossref 3. Gammon WR, Kowalewski C, Chorzelski TP, Kumar V, Briggaman RA, Buetner EH. Direct immunofluorescence studies of sodium chloride-separated skin in the differential diagnosis of bullous pemphigoid and epidermolysis bullosa acquisita . J Am Acad Dermatol. 1990;22:664-670.Crossref

Journal

Archives of DermatologyAmerican Medical Association

Published: Oct 1, 1990

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