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Abstract Blister or vesicle formation in human skin has no doubt been a recognized entity since man began, or at least since his first contact with fire. In view of this fact and the fact that there are more than 30 quite distinct dermatoses associated with blister formation, it is strange that so little is known about the actual mechanisms of blister formation. The primary purpose of this paper is to define what is known about the chemistry, morphology, and physiology of the epidermal and dermal components which may play a more or less direct role in blister formation. The various blister (vesicle) forming skin diseases certainly have a varied etiology. Among the well-established etiologic agents are: (1) virus invasion of the epidermal cell; (2) infection of the epidermis with fungi and bacteria; (3) sensitization of the skin (usually to simple chemicals); (4) vascular occlusion; (5) physical injury (heat, cold, ultraviolet References 1. Selby, C. C.: An Electron Microscope Study of the Epidermis of Mammalian Skin in Thin Sections: I. Dermo-Epidermal Junction and Basal Cell Layer , J. Biophys. & Biochem. Cytol. 1:429, 1955. 2. Laden, E. L.; Linden, I.; Erickson, J. O., and Armen, D. M.: Electron Microscopic Study of Epidermal Basal Cells and Epidermal Dermal Junction , J. Invest. Dermat. 21:37, 1953. 3. Porter, K.: Observations on the Submicroscopic Structure of Animal Epidermis , Anat. Rec. 118:443, 1954. 4. Dupré, A.: Histochemical Investigations of Human Skin: II. Intercellular Spaces , Ann. dermat. et syph. 80:490, 1953. 5. Naylor, P. F.: Experimental Friction Blisters , Brit. J. Dermat. 67:327, 1955. 6. Flesch, P.; Goldstone, S. B., and Weidman, F. D.: Blister Formation and Separation of the Epidermis from the Corium in Laboratory Animals , J. Invest. Dermat. 18:187, 1952. 7. Blank, I., and Miller, O. G.: A Method for the Separation of the Epidermis from the Dermis , J. Invest. Dermat. 15:9, 1950. 8. Rudall, K. M.: Proteins of the Mammalian Epidermis , Advances Protein Chem. 7:253, 1952. 9. Van Scott, E. J., and Flesch, P.: Sulfhydryl Groups and Disulfide Linkages in Normal and Pathologic Keratinization , A. M. A. Arch. Dermat. & Syph. 70:141, 1954. 10. Montagna, W.; Eisen, A. Z.; Rademacher, A. H., and Chase, H. B.: Histology and Cytochemistry of Human Skin: VI. Distribution of Sulfhydryl and Disulfide Groups , J. Invest. Dermat. 23:23-32, 1954. 11. Stoughton, R. B.: Unpublished experiments. 12. Stoughton, R. B.: Disruption of Epithelial Cells by Heat and Specific Chemical Agents , J. Invest. Dermat. , to be published. 13. Roe, D. A.: A Fibrous Keratin Precursor from the Human Epidermis: I. The Extraction and Physical Properties of a Fibrous Protein Found in the Human Epidermis , J. Invest. Dermat. 27:1, 1956. 14. Rothman, S., and others: Physiology and Biochemistry of The Skin , Chicago, University of Chicago Press, 1954. 15. Linderstrom-Lang, K., and Duspiva, F.: Keratin Digestion in the Larvae of the Clothes Moth , Nature , 135:1039, 1935. 16. Pillsbury, D.; Shelley, W. B., and Kligman, A. M.: Dermatology , Philadelphia, W. B. Saunders Company, 1956. 17. Nickerson, W. J., and Falcone, G.: Enzymatic Reduction of Disulfide Bonds in Cell Wall Protein of Baker's Yeast , Science 124:318, 1956. 18. Stoughton, R. B., and Novak, N.: Disruption of Tonofibrils and Intercellular Bridges by Disulfide Splitting Agents , J. Invest. Dermat. 26:127, 1956. 19. Wells, G. C., and Babcock, C.: Epidermal Protease , J. Invest. Dermat. 21:459, 1953. 20. Beloff, A., and Peters, R. A.: Observations upon Thermal Burns: The Influence of Moderate Temperature Burns upon Proteinase of Skin , J. Physiol. 103:461, 1945. 21. Axelrod, A. E., and Martin, C. J.: Biochemical Changes in Thermally-Injured Cutaneous Tissue, Susceptibility to Proteolytic Enzymes, and Extractability of Collagen , Proc. Soc. Exper. Biol. & Med. 83:463, 1953. 22. Fruton, J. S.: On the Proteolytic Enzymes of Animal Tissues: V. Peptidases of Skin, Lung, and Serum , J. Biol. Chem. 166:721, 1946. 23. Stoughton, R. B.: Enzymatic Cytolysis of Epithelium by Filtrates of Feces from Patients with Ulcerative Colitis , Science 116:37, 1952. 24. Cullumbine, H., and Rydon, H. N.: A Study on the Formation, Properties and Partial Purification of Leukotaxin , Brit. J. Exper. Path. 27:33, . 1946. 25. Zamecnik, P. C.; Stephenson, M. L., and Cope, O.: Peptidase Activity of Lymph and Serum After Burns . J. Biol. Chem. 158:135, 1945. 26. Stoughton, R. B., and Wells, G. C.: A Histochemical Study of Polysaccharides in Human Skin , J. Invest. Dermat. 14:37, 1950. 27. Baumberger, J. P.; Suntzeff, V., and Cowdry, E. V.: Methods for Separation of Epidermis from Dermis and Some Physiologic and Chemical Properties of Isolated Epidermis , J. Nat. Cancer Inst. 2:413, 1942. 28. Felsher, Z.: Studies on The Adherence of the Epidermis to the Corium , J. Invest. Dermat. 8:35, 1947.Crossref 29. Felsher, Z.: The Nature of Halogen Sensitivity in Dermatitis Herpetiformis and Pemphigus , J. Invest. Dermat. 8:55, 1956.Crossref 30. Stoughton, R. B., and Lorincz, A. L.: The Action of Collagenase on Skin and The Anti-Collagenase Factor in Human Serum , J. Invest. Dermat. 16:43, 1951. 31. Hambrick, G., and Blank, H.: Whole Mounts for the Study of Skin and Its Appendages , J. Invest. Dermat. 23:437, 1954.Crossref
A.M.A. Archives of Dermatology – American Medical Association
Published: Nov 1, 1957
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