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Immunofluorescence Microscopy Studies

Thomas K. Burnham, MB, BS(Lond); Linda P. Nims, MD

Arch Dermatol. 1982;118(7):506-511.

Abstract
• A 47-year-old man was diagnosed as having dermatitis herpetiformis (DH) in 1957. His failure to respond to therapy and the advent of immunofluorescent techniques led to a subsequent tentative diagnosis of vesicular pemphigoid (VP). High-titered, antibasal zone antibodies were present. However, unlike previously reported cases, direct immunofluorescence microscopy initially showed a DH-like and, later, an atypical granular band instead of a tubular (linear) band but with bullous pemphigoid (BP)-like immunoglobulin composition. No IgA was present. The patient's serum antibasal zone antibodies reacted with his perilesional skin despite granular deposits present at the same site, suggesting concomitant BP- and DH-like immunologic phenomena. The non-IgA-containing atypical granular band might be an immunologic marker for a subset of VP or another distinct disease entity demonstrating an immunologic overlap between BP and DH.

(Arch Dermatol 1982;118:506-511)

Author Affiliations
From the Department of Dermatology, Henry Ford Hospital, Detroit. Dr Nims is in private practice in Vienna, Va.

Footnotes
Accepted for publication Nov 25, 1981.

Reprint requests to Department of Dermatology, Henry Ford Hospital, Detroit, MI 48202 (Dr Burnham).

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