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Confocal Laser Scanning Microscopic and Immunoelectron Microscopic Studies of the Anatomical Distribution of Fibrillar IgA Deposits in Dermatitis Herpetiformis

Confocal Laser Scanning Microscopic and Immunoelectron Microscopic Studies of the Anatomical... Abstract • Background and Design.— The fibrillar immunofluorescent pattern of IgA deposition in dermatitis herpetiformis is considered by most authorities to be a variant of the granular IgA pattern. It has been hypothesized that the fibrillar vs the granular pattern is related to longitudinal vs transverse sectioning of affected dermal microfibril bundles. However, direct evidence for this possibility has yet to be presented. Confocal laser scanning microscopy and immunoelectron microscopy were performed to determine the anatomical distribution of fibrillar IgA deposits, using skin specimens from a patient with typical fibrillar IgA deposition. Observations.— Confocal laser scanning microscopy showed numerous fibrils stained with anti-IgA extending from the dermoepidermal junction to a depth of 50 to 110 μm in the dermis. They crossed each other at various angles to form a three-dimensional network. Immunoelectron microscopy demonstrated a diffuse dispersion of immune deposits on the surface of microfibrils of dermal microfibril bundles, with sporadic distribution of small aggregates, 0.1 to 0.3 μm in diameter. Conclusions.— To our knowledge, this is the first article to present evidence for the actual distribution of fibrillar IgA. Insofar as the present case is concerned, the distribution of fibrillar IgA is greatly at variance with that indicated in previous reports on granular IgA. However, studies on more cases should be conducted to determine whether this is a distinctive feature of the fibrillar type of IgA deposition.(Arch Dermatol. 1993;129:456-459) References 1. Chorzelski TP, Beutner EH, Jablonska S, Blaszczyk M, Triftshauser C. Immunofluorescence studies in the diagnosis of dermatitis herpetiformis and its differentiation from bullous pemphigoid . J Invest Dermatol. 1971;56:373-380.Crossref 2. Chorzelski TP, Jablonska S. Diagnostic significance of the immunofluorescent pattern in dermatitis herpetiformis . Int J Dermatol. 1975;14:429-436.Crossref 3. Yaoita H, Katz SI. Immunoelectronmicroscopic localization of IgA in skin of patients with dermatitis herpetiformis . J Invest Dermatol. 1976;67:502-506.Crossref 4. Stingl G, Honigsmann H, Holubar K, Wolff K. Ultrastructural localization of immunoglobulins in skin or patients with dermatitis herpetiformis . J Invest Dermatol. 1976;67:507-512.Crossref 5. Yaoita H. Identification of IgA binding structures in skin of patients with dermatitis herpetiformis . J Invest Dermatol. 1978;71: 213-216.Crossref 6. Chorzelski TP, Jablonska S, Beutner EH, Bean SF, Furey NL. Linear IgA bullous dermatosis . In: Beutner EH, Chorzelski TP, Bean SF, eds. Immunopathology of the Skin . 2nd ed. New York, NY: John Wiley & Sons Inc; 1979:315-319. 7. Leonard JN, Haffenden GP, Fry L. Dermatitis herpetiformis . In: Beutner EH, Chorzelski TP, Kumar V, eds. Immunopathology of the Skin . 3rd ed. New York, NY: John Wiley & Sons Inc; 1987:433-453. 8. White JG, Amos WB, Fordham M. An evaluation of confocal versus conventional imaging of biological structures by fluorescence light microscopy . J Cell Biol. 1987;105:41-48.Crossref 9. Nakane PK, Pieree GB. Enzyme-labeled antibodies: preparation and application for the localization of antigens . J Histochem Cytochem . 1966;14:929-931.Crossref 10. Briggaman RA, Wheeler CE Jr. The epidermal-dermal junction . J Invest Dermatol. 1975;65:71-84.Crossref 11. Cotta-Pereira G. Rodrigo FG, Bittencourt-Sampaio S. Oxytalan, elaunin, and elastic fibers in the human skin . J Invest Dermatol. 1976;66:143-148.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Confocal Laser Scanning Microscopic and Immunoelectron Microscopic Studies of the Anatomical Distribution of Fibrillar IgA Deposits in Dermatitis Herpetiformis

Archives of Dermatology , Volume 129 (4) – Apr 1, 1993

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Publisher
American Medical Association
Copyright
Copyright © 1993 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1993.01680250068008
Publisher site
See Article on Publisher Site

Abstract

Abstract • Background and Design.— The fibrillar immunofluorescent pattern of IgA deposition in dermatitis herpetiformis is considered by most authorities to be a variant of the granular IgA pattern. It has been hypothesized that the fibrillar vs the granular pattern is related to longitudinal vs transverse sectioning of affected dermal microfibril bundles. However, direct evidence for this possibility has yet to be presented. Confocal laser scanning microscopy and immunoelectron microscopy were performed to determine the anatomical distribution of fibrillar IgA deposits, using skin specimens from a patient with typical fibrillar IgA deposition. Observations.— Confocal laser scanning microscopy showed numerous fibrils stained with anti-IgA extending from the dermoepidermal junction to a depth of 50 to 110 μm in the dermis. They crossed each other at various angles to form a three-dimensional network. Immunoelectron microscopy demonstrated a diffuse dispersion of immune deposits on the surface of microfibrils of dermal microfibril bundles, with sporadic distribution of small aggregates, 0.1 to 0.3 μm in diameter. Conclusions.— To our knowledge, this is the first article to present evidence for the actual distribution of fibrillar IgA. Insofar as the present case is concerned, the distribution of fibrillar IgA is greatly at variance with that indicated in previous reports on granular IgA. However, studies on more cases should be conducted to determine whether this is a distinctive feature of the fibrillar type of IgA deposition.(Arch Dermatol. 1993;129:456-459) References 1. Chorzelski TP, Beutner EH, Jablonska S, Blaszczyk M, Triftshauser C. Immunofluorescence studies in the diagnosis of dermatitis herpetiformis and its differentiation from bullous pemphigoid . J Invest Dermatol. 1971;56:373-380.Crossref 2. Chorzelski TP, Jablonska S. Diagnostic significance of the immunofluorescent pattern in dermatitis herpetiformis . Int J Dermatol. 1975;14:429-436.Crossref 3. Yaoita H, Katz SI. Immunoelectronmicroscopic localization of IgA in skin of patients with dermatitis herpetiformis . J Invest Dermatol. 1976;67:502-506.Crossref 4. Stingl G, Honigsmann H, Holubar K, Wolff K. Ultrastructural localization of immunoglobulins in skin or patients with dermatitis herpetiformis . J Invest Dermatol. 1976;67:507-512.Crossref 5. Yaoita H. Identification of IgA binding structures in skin of patients with dermatitis herpetiformis . J Invest Dermatol. 1978;71: 213-216.Crossref 6. Chorzelski TP, Jablonska S, Beutner EH, Bean SF, Furey NL. Linear IgA bullous dermatosis . In: Beutner EH, Chorzelski TP, Bean SF, eds. Immunopathology of the Skin . 2nd ed. New York, NY: John Wiley & Sons Inc; 1979:315-319. 7. Leonard JN, Haffenden GP, Fry L. Dermatitis herpetiformis . In: Beutner EH, Chorzelski TP, Kumar V, eds. Immunopathology of the Skin . 3rd ed. New York, NY: John Wiley & Sons Inc; 1987:433-453. 8. White JG, Amos WB, Fordham M. An evaluation of confocal versus conventional imaging of biological structures by fluorescence light microscopy . J Cell Biol. 1987;105:41-48.Crossref 9. Nakane PK, Pieree GB. Enzyme-labeled antibodies: preparation and application for the localization of antigens . J Histochem Cytochem . 1966;14:929-931.Crossref 10. Briggaman RA, Wheeler CE Jr. The epidermal-dermal junction . J Invest Dermatol. 1975;65:71-84.Crossref 11. Cotta-Pereira G. Rodrigo FG, Bittencourt-Sampaio S. Oxytalan, elaunin, and elastic fibers in the human skin . J Invest Dermatol. 1976;66:143-148.Crossref

Journal

Archives of DermatologyAmerican Medical Association

Published: Apr 1, 1993

References