Diagnosis of autoimmune subepidermal bullous diseases with mucous membrane involvement based on laser-scanning confocal microscopy View Full Text


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Article Info

DATE

2020-10-01

AUTHORS

Katarzyna Wozniak, Beata Jakubowska, Agnieszka Kalinska-Bienias, Takashi Hashimoto, Norito Ishii, Cezary Kowalewski

ABSTRACT

BackgroundMucosal involvement in autoimmune subepidermal blistering disorders (ASBD) may represent the only or predominant localization. Circulating autoantibodies are detected in 50% cases.ObjectiveThe aim of this study was to evaluate the usefulness of fluorescence overlay antigen mapping by laser-scanning confocal microscopy (FOAM-LSCM) to identify ASBD with mucosal involvement in oral mucosa specimens.Materials & MethodsThirty-two ASBD patients, diagnosed based on direct immunofluorescence between 2006 and 2016, were enrolled. Localization of IgG deposits bound at the basement membrane zone, relative to laminin-332 and collagen IV localization, was assessed in vivo.ResultsFOAM-LSCM disclosed four different immunofluorescence patterns. IgG deposits were located above laminin-332, as in bullous pemphigoid (BP-type), in 19% cases and co-localized with laminin-332 (anti-laminin-332-type) in 6% cases. IgG deposits were found below laminin-332 and above collagen IV (mucous membrane pemphigoid-type) in 59% cases, and below collagen IV (epidermolysis bullosa acquisita-type) in 16%. Circulating antibodies were found in 56% cases.ConclusionThe FOAM-LSCM method should be used in order to obtain a definitive diagnosis of ASBD with mucosal involvement, particularly in the presence of negative circulating antibodies More... »

PAGES

516-523

Identifiers

URI

http://scigraph.springernature.com/pub.10.1684/ejd.2020.3765

DOI

http://dx.doi.org/10.1684/ejd.2020.3765

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https://app.dimensions.ai/details/publication/pub.1131171121

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/32972911


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