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Dermatology. 2001;203(4):289-93.

Diagnosing Pemphigus foliaceus: a retrospective analysis of clinical, histological and immunological criteria.

Author information

1
Section of Dermatology, DiSEM, Genoa, Italy.

Abstract

BACKGROUND:

Clinical, histological and immunological criteria distinguish pemphigus foliaceus (PF) from pemphigus vulgaris (PV), but whether and how often they are concordant in the same patient is unknown.

METHODS:

Seven clinical records were selected from two hospital settings for having a diagnosis of PF and the initial serum and histopathological specimens still available. Controls were 8 PV records selected in the same way. Histopathological slides were re-evaluated. Stored sera were studied by indirect immunofluorescence (IIF), Western blot and ELISA.

RESULTS:

Acantholysis was superficial in all PF patients and deep in all PV patients. Mucosal lesions were not exclusive of PV. IIF was positive in 43% of PF patients. Western blot revealed desmoglein 1 in 86% of PF patients and in 25% of PV. ELISA revealed anti-desmoglein-1 antibodies in up to 71% of PF and in 62% of PV patients, in 1 failing to detect anti-desmoglein-3 antibodies.

CONCLUSIONS:

Histopathology remains the most reliable criterion for diagnosing PF. Western blot and ELISA, especially in combination, may be only of confirmatory value.

PMID:
11752814
DOI:
10.1159/000051774
[Indexed for MEDLINE]

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