Studies in Bullous Diseases

Abstract

The indirect immunofluorescent technic has proved of value in differential diagnosis of bullous diseases. Of 24 patients with pemphigus vulgaris studied, serums of 16 demonstrated an intercellular antiepithelial antibody. There was a definite relation between clinical activity and antibody titer. Of nine patients with bullous pemphigoid, serums in six showed antibodies specific for basement zone. Serial antibody titers in both diseases are of clinical value as guides to management of corticoid therapy. Further evidence is needed before etiologic importance can be ascribed to these autoantibodies. One patient had positive intercellular antibodies demonstrable in serum four years before clinical and histologic evidence of pemphigus vulgaris developed. Another whose serum shows intercellular antibodies has yet not demonstrated acantholysis. Therefore, a potential form of pemphigus vulgaris is postulated. Four of 24 patients with pemphigus vulgaris have concurrent myasthenia gravis.