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Localized Chronic Pemphigoid of Brunsting-Perry: Ultrastructural Localization of IgG and Complement Components

Localized Chronic Pemphigoid of Brunsting-Perry: Ultrastructural Localization of IgG and... Abstract • Immune electron microscopic data are presented of a typical case of localized chronic pemphigoid (LCP) of Brunsting-Perry. The peroxidase-antiperoxidase multistep method for the electron microscopic localization of immunoglobulins and complement components showed that IgG, C3, and C4 were distributed in the lamina lucida and on the undersurface of the basal keratinocytes. These findings support the concept that LCP, bullous pemphigoid, and benign mucosal pemphigoid are closely related diseases. Unlike in bullous pemphigoid, however, complement was occasionally found in this case of LCP beyond the basal lamina in the uppermost portion of the dermis. This finding may explain the occurrence of scar formation in LCP. (Arch Dermatol 1983;119:921-924) References 1. Brunsting LA, Perry HO: Benign pemphigoid? A report of seven cases with chronic, scarring, herpetiform plaques about the head and neck . Arch Dermatol 1957;75:489-501.Crossref 2. Graham JH, MacVicar DN: Bullous dermatosis , in Graham JH, Johnson WC, Helwig EF (eds): Dermal Pathology . Hagerstown, Md, Harper & Row Publishers Inc, 1972, pp 269-323. 3. Moschella SL: Benign mucosal pemphigoid , in Moschella SL, Pillsbury DM, Hurley HJ Jr (eds): Dermatology . Philadelphia, WB Saunders Co, 1975, pp 466-468. 4. Jacoby WD Jr, Bartholome CW, Ramchand SC, et al: Cicatricial pemphigoid (Brunsting-Perry type): Case report and immuno- fluorescence findings . Arch Dermatol 1978;114:779-781.Crossref 5. Michel B, Bean SF, Chorzelski T, et al: Cicatricial pemphigoid of Brunsting-Perry: Immunofluorescent studies . Arch Dermatol 1977;113:1403-1405.Crossref 6. Bean SF: Cicatricial pemphigoid . Int J Dermatol 1975;14:23-26.Crossref 7. Dantzig P: Circulating antibodies in cicatricial pemphigoid . Arch Dermatol 1973;108:264-266.Crossref 8. Griffith MR, Fukuyama K, Tuffanelli D, et al: Immunofluorescent studies in mucous membrane pemphigoid . Arch Dermatol 1974;109:195-199.Crossref 9. Bean SF: Cicatricial pemphigoid: A study of 15 cases . South Med J 1974;67:1187-1190.Crossref 10. Dabelsteen E, Ullman S, Thomsen K, et al: Demonstration of basement membrane autoantibodies in patients with benign mucous membrane pemphigoid . Acta Derm Venereol 1974;54:189-192. 11. Tagami H, Imamura S: Benign mucous membrane pemphigoid: Demonstration of circulating and tissue-bound membrane antibodies . Arch Dermatol 1974;109:711-713.Crossref 12. Rogers RS III, Perry HO, Bean SF, et al: Immunopathology of cicatricial pemphigoid: Studies of complement deposition . J Invest Dermatol 1977;68:39-43.Crossref 13. Person JR, Rogers RS III: Bullous and cicatricial pemphigoid: Clinical, histopathologic, and immunopathologic correlations . Mayo Clin Proc 1977;52:54-66. 14. Person JR, Rogers RS III, Jordon RE: Cicatricial pemphigoid with circulating anti-basement membrane antibodies: Report of three atypical cases . Dermatologica 1977;154:90-97. 15. Bean SF, Rogers RS, Jordon RE, et al: Cicatricial pemphigoid , in Beutner EH, Chorzelski TP, Bean SF (eds): Immunopathology of the Skin , ed 2. New York, John Wiley & Sons Inc, 1979, pp 257-263. 16. Sternberger LA, Hardy PH Jr, Cuculis JJ, et al: The unlabeled antibody enzyme method of immunohistochemistry: Preparation and properties of soluble antigen-antibody complex (horseradish peroxidase-antihorseradish peroxidase) and its use in identification of spirochetes . J Histochem Cytochem 1970;18:315-333.Crossref 17. Holubar K, Wolff K, Konrad K, et al: Ultrastructural localization of immunoglobulins in bullous pemphigoid skin: Employment of a new peroxidase-antiperoxidase multistep method . J Invest Dermatol 1975;64:220-227.Crossref 18. Yaoita H, Gullino M, Katz SI: Herpes gestationis: Ultrastructure and ultrastructural localization of in vivo-bound complement: Modified tissue preparation and processing for horseradish peroxidase staining of skin . J Invest Dermatol 1976;66:383-388.Crossref 19. Graham RC Jr, Karnovsky MJ: The early stages of absorption of injected horseradish peroxidase in the proximal tubules of mouse kidney: Ultrastructural cytochemistry by a new technique . J Histochem Cytochem 1966;14:291-302.Crossref 20. Schaumburg-Lever G, Rule A, Schmidt-Ullrich B, et al: Ultrastructural localization of in vivo-bound immunoglobulins in bullous pemphigoid: A preliminary report . J Invest Dermatol 1975;64:47-49.Crossref 21. Schmidt-Ullrich B, Rule A, Schaumburg-Lever G, et al: Ultrastructural localization of in vivo-bound complement in bullous pemphigoid . J Invest Dermatol 1975;65:217-219.Crossref 22. Albini B, Holubar K, Shu S, et al: Enzyme antibody methods in immunodermatopathology , in Beutner EH, Chorzelski TP, Bean SF (eds): Immunopathology of the Skin , ed 2. New York, John Wiley & Sons Inc, 1979, pp 93-134. 23. Wolff-Schreiner E, Wolff K: Immunoglobulins at the dermal-epidermal junction in lupus erythematosus: Ultrastructural investigations . Arch Dermatol 1973;246:193-210.Crossref 24. Nieboer C, Boorsma DM, Woerdeman MJ, et al: Epidermolysis bullosa acquisita: Immunofluorescence, electron microscopic and immunoelectron microscopic studies in four patients . Br J Dermatol 1980;102:383-392.Crossref 25. Yaoita H, Briggaman RA, Lawley TJ, et al: Epidermolysis bullosa acquisita: Ultrastructural and immunological studies . J Invest Dermatol 1981;76:288-292.Crossref 26. Schreiner E, Wolff K: Systemic lupus erythematosus: Electron microscopic localization of in vivo bound globulins at the dermal-epidermal junction . J Invest Dermatol 1970;55:325-328.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Localized Chronic Pemphigoid of Brunsting-Perry: Ultrastructural Localization of IgG and Complement Components

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Publisher
American Medical Association
Copyright
Copyright © 1983 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1983.01650350049014
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Abstract

Abstract • Immune electron microscopic data are presented of a typical case of localized chronic pemphigoid (LCP) of Brunsting-Perry. The peroxidase-antiperoxidase multistep method for the electron microscopic localization of immunoglobulins and complement components showed that IgG, C3, and C4 were distributed in the lamina lucida and on the undersurface of the basal keratinocytes. These findings support the concept that LCP, bullous pemphigoid, and benign mucosal pemphigoid are closely related diseases. Unlike in bullous pemphigoid, however, complement was occasionally found in this case of LCP beyond the basal lamina in the uppermost portion of the dermis. This finding may explain the occurrence of scar formation in LCP. (Arch Dermatol 1983;119:921-924) References 1. Brunsting LA, Perry HO: Benign pemphigoid? A report of seven cases with chronic, scarring, herpetiform plaques about the head and neck . Arch Dermatol 1957;75:489-501.Crossref 2. Graham JH, MacVicar DN: Bullous dermatosis , in Graham JH, Johnson WC, Helwig EF (eds): Dermal Pathology . Hagerstown, Md, Harper & Row Publishers Inc, 1972, pp 269-323. 3. Moschella SL: Benign mucosal pemphigoid , in Moschella SL, Pillsbury DM, Hurley HJ Jr (eds): Dermatology . Philadelphia, WB Saunders Co, 1975, pp 466-468. 4. Jacoby WD Jr, Bartholome CW, Ramchand SC, et al: Cicatricial pemphigoid (Brunsting-Perry type): Case report and immuno- fluorescence findings . Arch Dermatol 1978;114:779-781.Crossref 5. Michel B, Bean SF, Chorzelski T, et al: Cicatricial pemphigoid of Brunsting-Perry: Immunofluorescent studies . Arch Dermatol 1977;113:1403-1405.Crossref 6. Bean SF: Cicatricial pemphigoid . Int J Dermatol 1975;14:23-26.Crossref 7. Dantzig P: Circulating antibodies in cicatricial pemphigoid . Arch Dermatol 1973;108:264-266.Crossref 8. Griffith MR, Fukuyama K, Tuffanelli D, et al: Immunofluorescent studies in mucous membrane pemphigoid . Arch Dermatol 1974;109:195-199.Crossref 9. Bean SF: Cicatricial pemphigoid: A study of 15 cases . South Med J 1974;67:1187-1190.Crossref 10. Dabelsteen E, Ullman S, Thomsen K, et al: Demonstration of basement membrane autoantibodies in patients with benign mucous membrane pemphigoid . Acta Derm Venereol 1974;54:189-192. 11. Tagami H, Imamura S: Benign mucous membrane pemphigoid: Demonstration of circulating and tissue-bound membrane antibodies . Arch Dermatol 1974;109:711-713.Crossref 12. Rogers RS III, Perry HO, Bean SF, et al: Immunopathology of cicatricial pemphigoid: Studies of complement deposition . J Invest Dermatol 1977;68:39-43.Crossref 13. Person JR, Rogers RS III: Bullous and cicatricial pemphigoid: Clinical, histopathologic, and immunopathologic correlations . Mayo Clin Proc 1977;52:54-66. 14. Person JR, Rogers RS III, Jordon RE: Cicatricial pemphigoid with circulating anti-basement membrane antibodies: Report of three atypical cases . Dermatologica 1977;154:90-97. 15. Bean SF, Rogers RS, Jordon RE, et al: Cicatricial pemphigoid , in Beutner EH, Chorzelski TP, Bean SF (eds): Immunopathology of the Skin , ed 2. New York, John Wiley & Sons Inc, 1979, pp 257-263. 16. Sternberger LA, Hardy PH Jr, Cuculis JJ, et al: The unlabeled antibody enzyme method of immunohistochemistry: Preparation and properties of soluble antigen-antibody complex (horseradish peroxidase-antihorseradish peroxidase) and its use in identification of spirochetes . J Histochem Cytochem 1970;18:315-333.Crossref 17. Holubar K, Wolff K, Konrad K, et al: Ultrastructural localization of immunoglobulins in bullous pemphigoid skin: Employment of a new peroxidase-antiperoxidase multistep method . J Invest Dermatol 1975;64:220-227.Crossref 18. Yaoita H, Gullino M, Katz SI: Herpes gestationis: Ultrastructure and ultrastructural localization of in vivo-bound complement: Modified tissue preparation and processing for horseradish peroxidase staining of skin . J Invest Dermatol 1976;66:383-388.Crossref 19. Graham RC Jr, Karnovsky MJ: The early stages of absorption of injected horseradish peroxidase in the proximal tubules of mouse kidney: Ultrastructural cytochemistry by a new technique . J Histochem Cytochem 1966;14:291-302.Crossref 20. Schaumburg-Lever G, Rule A, Schmidt-Ullrich B, et al: Ultrastructural localization of in vivo-bound immunoglobulins in bullous pemphigoid: A preliminary report . J Invest Dermatol 1975;64:47-49.Crossref 21. Schmidt-Ullrich B, Rule A, Schaumburg-Lever G, et al: Ultrastructural localization of in vivo-bound complement in bullous pemphigoid . J Invest Dermatol 1975;65:217-219.Crossref 22. Albini B, Holubar K, Shu S, et al: Enzyme antibody methods in immunodermatopathology , in Beutner EH, Chorzelski TP, Bean SF (eds): Immunopathology of the Skin , ed 2. New York, John Wiley & Sons Inc, 1979, pp 93-134. 23. Wolff-Schreiner E, Wolff K: Immunoglobulins at the dermal-epidermal junction in lupus erythematosus: Ultrastructural investigations . Arch Dermatol 1973;246:193-210.Crossref 24. Nieboer C, Boorsma DM, Woerdeman MJ, et al: Epidermolysis bullosa acquisita: Immunofluorescence, electron microscopic and immunoelectron microscopic studies in four patients . Br J Dermatol 1980;102:383-392.Crossref 25. Yaoita H, Briggaman RA, Lawley TJ, et al: Epidermolysis bullosa acquisita: Ultrastructural and immunological studies . J Invest Dermatol 1981;76:288-292.Crossref 26. Schreiner E, Wolff K: Systemic lupus erythematosus: Electron microscopic localization of in vivo bound globulins at the dermal-epidermal junction . J Invest Dermatol 1970;55:325-328.Crossref

Journal

Archives of DermatologyAmerican Medical Association

Published: Nov 1, 1983

References