PEMPHIGUS

Abstract

SEVERAL reports have appeared recently, particularly in the French and Belgian literature, stressing that the bulla of pemphigus has a characteristic histologic structure. Because of these reports, all histologic sections obtained at the Massachusetts General Hospital since 1936 from the skin and mucous membranes of patients with pemphigus were reviewed. Sections were available from 65 patients, all of whom I have had an opportunity to observe and follow. Study of these sections confirms the conclusion drawn by the European writers that histologic examination is of great value in the diagnosis of pemphigus. REVIEW OF LITERATURE It seems to have been the consensus of all observers up to recent times that the bulla of pemphigus had no diagnostic histologic appearance and could not be differentiated from the bullae occurring in dermatitis herpetiformis and erythema multiforme.¹ In 1943, Civatte² stated that the bulla of pemphigus presented characteristic histologic features which permitted differentiation from the bullae of dermatitis herpetiformis