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Ultrastructural Aspects of Mucosas in Endemic Pemphigus Foliaceus
Antonio Carlos Martins Guedes, MD, PhD;
Osmar Rotta, MD, PhD;
Henrique Vitor Leite, MD, PhD;
Virginia Hora Rios Leite, MD, PhD
Arch Dermatol. 2002;138:949-954.
Objective To investigate whether ultrastructural changes present in clinically
normal oral mucosa could occur in the mucosas of patients with endemic pemphigus
foliaceus (EPF) or fogo selvagem (wildfire).
Patients Surgical biopsy specimens were taken from the foreskin of 8 patients
with EPF and 3 control subjects, the uterine cervix and vaginal wall of 9
patients with EPF and 2 controls, and the oral mucosa of 5 patients with EPF
and 4 controls. The patients received a clinical and histopathologic diagnosis
of EPF and all had clinically normal oral and genital mucosas.
Results In the patients with EPF, widening of the intercellular spaces and distended,
elongated cytoplasmic projections, the tips of which contained desmosomes
and were sometimes disassembled, were evident in all 4 regions studied. At
the periphery of the spinous cells, cytoplasmic vesicles apparently containing
intact or fragments of desmosomes or half-desmosomes were seen.
Conclusions The ultrastructural lesions found in the mucosas studied are similar
to those previously described in the literature for the oral mucosa of patients
with EPF. In the cases of EPF, even though the desmosomal changes occurred
in all epithelial layers, blisters did not occur in the mucosas by possible
coexpression of desmoglein 1 and desmoglein 3.
From the School of Medicine, Federal University of Minas Gerais, Belo
Horizonte (Drs Guedes, H. V. Leite, and V. H. R. Leite), and School of Medicine,
Federal University of São Paulo, São Paulo (Dr Rotta), Brazil.
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