Pathogenesis of pemphigus erythematosus

Abstract

Immunofluorescence studies were made by the indirect method in 54 cases of pemphigus erythematosus, in 50 of which skin specimens from light-exposed and unexposed regions were investigated also by the direct IF method. IF Band was shown to be demonstrable in skin specimens from exposed regions in 81% of cases and from unexposed regions in 23%. ANA were found in some 31% of patients, though usually in titers below those of IC antibodies. There were 2 cases each of coexistence with myastenia gravis and thymoma and with SLE. Virus-like particles, however, were found by electron microscopy only in 1 case with coexisting SLE. Detection of IF Band in skin specimens from a significant majority of patients with pemphigus erythematosus, presence of ANA in some, and occasional coexistence of SLE suggest some relation of the disease with lupus erythematosus.

Unusual Immunofluorescence Findings in Pemphigus vegetans

“…Both intraepidermal and basement mem brane deposits have been demonstrated re peatedly in exposed skin lesions of pemphi gus erythematosus [4], but clinically this case was definitely not pemphigus erythe matosus.…”

Concurrence of Systemic Lupus Erythematosus and Pemphigus: Coincidence or Correlation?

“…Five had only cutaneous lesions with or without oral ulcers in addition to serological markers for SLE [22, 24, 31, 32, 34]. Seven patients had additional symptoms of SLE including renal, pleural, cardiac or CNS involvement [5,23,24,25,26, 28]. …”

“…Clinically, none had oral involvement. In 2 of these 11 patients, the authors did not report performing DIF [25]. Seven had immunoreactant deposition at both the DEJ and ICS, and these are considered to have PE.…”

“…In the cases where pemphigus was reported with the presence of a thymoma [25,29,30,31, 33] or adenocarcinoma [20], a diagnosis of paraneoplastic pemphigus (PNP) is unlikely for several reasons: (1) there was no oral involvement in these cases, whereas recalcitrant mucositis is a constant feature of PNP; (2) the authors did not report antibodies directed against desmoplakins or bullous pemphigoid antigen; (3) the patients did not have the pulmonary injury (alveolitis) reported in 30–40% of PNP patients, and (4) thymomas or adenocarcinomas are not reported to frequently occur in PNP patients. Hence, the diagnosis in these patients is more consistent with PV, PF or PE but not with PNP.…”

Pruritic, Pink Scaling Plaques on the Face and Trunk

“…Direct immunofluorescence demonstrates IgG and C3 deposition intercellularly and along the basement membrane in continuous and granular patterns, similar to the "lupus band." 3,4 This mixed pattern may be seen in PE and paraneoplastic pemphigus. Abnormal laboratory findings may be noted in patients with PE.…”