Pemphigoid: clinical, histologic, immunopathologic, and therapeutic considerations.
Autoimmune blistering diseases are generally distinct entities characterized by relatively consistent clinical, histologic, and immunopathologic findings. These disorders may cause impaired adhesion of epidermis to epidermal basement membrane (eg, the pemphigoid group of disorders [bullous, gestational, and mucous membrane]) or impaired adhesion of epidermal cells to each other (eg, the pemphigus group of disorders). Recent studies have shown that these disorders are characterized by autoantibodies that often display pathogenic (ie, blister-forming) activity in passive transfer models. Interestingly, the autoantigens targeted by these patients' autoantibodies represent important structural proteins that promote cell matrix (eg, pemphigoid) or cell-to-cell (eg, pemphigus) adhesion in skin. Autoimmune blistering diseases are characterized by substantial morbidity (pruritus, pain, disfigurement), and in some instances, mortality (secondary to loss of epidermal barrier function). Treatment with systemic immunosuppressives has reduced morbidity and mortality in patients with these diseases. JAMA. 2000;284:350-356
Yancey
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Dermatology Branch, Division of Clinical Sciences, National Cancer Institute, Bldg 10, Room 12N238, National Institutes of Health, 10 Center Dr, MSC 1908, Bethesda, MD 20892-1908, USA. Kim_B_Yancey@nih.gov
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D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001323:Autoantibodies; D001379:Azathioprine / Q000627:therapeutic use; D001485:Basement Membrane; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D010391:Pemphigoid, Bullous / Q000188:drug therapy / Q000276:immunology / Q000473:pathology / Q000503:physiopathology; D011241:Prednisone / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D001323:Autoantibodies; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D001379:Azathioprine; D011241:Prednisone