Comparisons of pathologic and normal skin reactive autoantibodies and the interference phenomenon.

Immunofluorescent serum studies of the roles of the two groups of normal complement-fixing autoantibodies in psoriasis are complicated by the interference phenomenon. Both antibodies have the potential to react in vivo at sites of trauma and in psoriasiform lesions. In serum tests, only one or the other reacts, as demonstrated by immunofluorescent serum tests and absorption studies with isolated stratum corneum antigen.

Can direct immunofluorescence testing still be accurate if performed on biopsy specimens after brief inadvertent immersion in formalin?

Background: Direct immunofluorescence is useful in the diagnosis of autoimmune, vesiculobullous, and connective tissue diseases. Michel medium is typically indicated for transport, but clinicians may inadvertently place samples into formalin.

Objective: We set out to determine the amount of time that specimens can remain in 10% buffered formalin and still retain their diagnostic properties.

A case of bullous disease limited to the skin illustrates the spectrum of neoplasia-induced autoimmunity.

Although the initial report of paraneoplastic pemphigus described individuals with mucocutaneous blistering disease, subsequent reports identified patients with lichen planus or graft versus host disease-like changes. We describe a patient with fatal autoimmune blistering disease with absence of mucous membrane lesions. The pattern of complement indirect immunofluoresence helped identify the prognosis prospectively.

Intravenous immunoglobulin selectively decreases circulating autoantibodies in pemphigus.

Background: Autoantibody-mediated diseases such as pemphigus are caused by a single or very limited number of pathogenic autoantibodies. A major problem with all current therapies for these diseases is that they target all antibodies rather than selectively targeting only pathogenic antibodies. The following study was conducted to confirm observations made in a limited number of patients that suggest intravenous immunoglobulin (IVIg) may be able to selectively lower serum levels of only abnormal autoantibodies.

Analyses of autoantigens in a new form of endemic pemphigus foliaceus in Colombia.

Background: We previously described a new focus of endemic pemphigus foliaceus in rural areas of El Bagre, Colombia, with clinical and direct immunofluorescence characteristics of pemphigus erythematosus.

Objective: The aim of this study was to characterize autoantigen profiles for 34 serum samples obtained from patients with this condition.

Methods: Immunofluorescence, various immunoblot analyses with different antigen sources and detection methods, and immunoprecipitation were performed.

A unique form of endemic pemphigus in northern Colombia.

Background: Endemic forms of pemphigus are a unique group of autoimmune diseases that represent opportunities to study interactions of the environment and genetics with the immune system. The restriction to relatively well-defined regions of South and Central America and perhaps Africa characterizes these diseases.

Objectives: The aims of this study were to confirm the endemic nature of a new type of autoimmune disease occurring in a mining town in northeastern Colombia in the El Bagre area, to characterize it, and to compare it with other forms of endemic pemphigus.

A nonfatal case and 2 fatal cases of paraneoplastic pemphigus: can a complement indirect immunofluorescent test help to identify fatal "group A" paraneoplastic pemphigus cases?

We studied 3 recent cases of paraneoplastic pemphigus (PNP) in detail. Two patients died despite concerted management efforts. One patient received no treatment after the appearance of PNP and recovered completely from both PNP and lymphoma.

Bullous skin disease: an unusual allergic reaction to vancomycin.

Severe reactions due to vancomycin are uncommon. We describe a case of vancomycin-induced linear immunoglobulin A bullous disease and review the literature pertinent to this entity. This is a rare subepidermal blistering disorder, with a heterogenous clinical presentation.

Diagnostic features of pemphigus vulgaris in patients with bullous pemphigoid. Molecular analysis of autoantibody profile.

Background: The simultaneous presence of features of pemphigus vulgaris (PV) in patients with bullous pemphigoid (BP) has previously been reported in the literature.

Objective: The purpose of this retrospective study is to present 13 patients with an initial diagnosis of BP, who subsequently demonstrated coexistent serological features of both BP and PV.

Methods: The following information on each patient was documented, at the time of initial diagnosis: clinical profile on presentation, histology, direct immunofluorescence, indirect immunofluorescence (IIF) using monkey esophagus as substrate, salt-split skin (SSS) and an immunoblot assay.