title: Immunohistopathological study of autoimmune pemphigus. Lack of strictly specific histological and indirect immunofluorescence criteria for paraneoplastic pemphigus.
abstract: Paraneoplastic pemphigus (PNP) is a form of pemphigus considered to bear characteristic immunohistopathological features (vacuolar-interface dermatitis, keratinocyte dyskeratosis and reactivity of patients' sera with transitional epithelia). The present study was undertaken in order to investigate whether these criteria are specific enough so as to allow the diagnosis of PNP in the absence of clinical data. A retrospective study of 66 biopsies of pemphigus revealed that one third of them comprised histological signs of PNP; one of the corresponding sera reacted with mouse bladder epithelium. However, no evidence of a neoplastic disease was present in any of the patients, and Western blotting further excluded the diagnosis of PNP. These results suggest that some of the features considered characteristic of PNP are not strictly specific for this variety of pemphigus; hence this diagnosis cannot be reliably established by histology or immunofluorescence but requires biochemical studies.
authors.affiliation: Department of Dermatology, Hôpital Edouard Herriot, Lyon, France.
authors.forename: J
authors.initials: J
authors.lastname: Kanitakis
authors.forename: Y Z
authors.initials: YZ
authors.lastname: Wang
authors.forename: P
authors.initials: P
authors.lastname: Roche
authors.forename: E
authors.initials: E
authors.lastname: Cozzani
authors.forename: J F
authors.initials: JF
authors.lastname: Nicolas
authors.forename: Y
authors.initials: Y
authors.lastname: Sarret
authors.forename: J
authors.initials: J
authors.lastname: Thivolet
mesh_terms: D000051:Acantholysis / Q000473:pathology; D000328:Adult; D001327:Autoimmune Diseases / Q000473:pathology*; D001485:Basement Membrane / Q000473:pathology; D015153:Blotting, Western; D003176:Complement C3 / Q000032:analysis; D003593:Cytoplasm / Q000648:ultrastructure; D004817:Epidermis / Q000473:pathology; D005455:Fluorescent Antibody Technique; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007150:Immunohistochemistry; D015603:Keratinocytes / Q000473:pathology; D008297:Male; D010257:Paraneoplastic Syndromes / Q000276:immunology* / Q000473:pathology*; D010392:Pemphigus / Q000276:immunology* / Q000473:pathology*; D011233:Precipitin Tests; D012189:Retrospective Studies
chemical_list: D003176:Complement C3; D007074:Immunoglobulin G