title: Localization of bullous pemphigoid antibody--an indirect immunofluorescence study of 228 cases using a split-skin technique.
abstract: We have re-examined the site of deposition of IgG anti-basement membrane zone antibodies in 228 sera from suspected cases of bullous pemphigoid (BP), using 1.0 M sodium chloride split-skin as substrate for indirect immunofluorescence. Nine sera (4%) produced fluorescence on the floor of the split suggesting sub-basal lamina antibody deposition compatible with a diagnosis of epidermolysis bullosa acquisita (EBA). This ultrastructural localization was confirmed in only three of these nine by immuno-electron microscopy. Clinical details were available on six of these nine cases, and none had clinical features suggesting EBA. We have found the split-skin immunofluorescence technique unhelpful in identifying 'missed' cases of EBA. The prevalence of EBA presenting as BP would appear to be very low indeed in the U.K.
authors.affiliation: United Medical Schools of Guy's Hospital, London, U.K.
authors.forename: R A
authors.initials: RA
authors.lastname: Logan
authors.forename: B
authors.initials: B
authors.lastname: Bhogal
authors.forename: A K
authors.initials: AK
authors.lastname: Das
authors.forename: P M
authors.initials: PM
authors.lastname: McKee
authors.forename: M M
authors.initials: MM
authors.lastname: Black
mesh_terms: D001485:Basement Membrane / Q000276:immunology; D004820:Epidermolysis Bullosa / Q000276:immunology; D005455:Fluorescent Antibody Technique; D006652:Histological Techniques; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis*; D010391:Pemphigoid, Bullous / Q000276:immunology*; D012867:Skin / Q000276:immunology*; D012872:Skin Diseases, Vesiculobullous / Q000276:immunology*
chemical_list: D007074:Immunoglobulin G