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PL5 The diagnosis of sub-epithelial bullous diseases

Lookup NU author(s): Professor Marco Carrozzo


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There are a number of sub-epithelial vesiculobullous disorders that may produce similar clinical pictures in the oral cavity, with antibodies directed against various hemidesmosomal components or components of the epithelial basement membrane. The term immune-mediated sub-epithelial blistering diseases (IMSEBD) have therefore been used. The diagnosis of IMSEBD on clinical grounds alone is impossible and a full history, general, and oral examination, biopsy with immunostaining are now invariably required, sometimes supplemented with other special investigations. The main subepithelial blistering disease is mucous membrane pemphigoid (MMP) that includes a range of variants frequently having oral and especially gingival lesions. Exclusive oral MMP (OP) has been reported to have frequently a low frequency of positive indirect immunofluorescence (IIF) findings without serologic reactivity to recognised MMP antigens. However, the low frequency of detection of autoantibodies in the sera of OP patients may be due to insufficiently sensitive detection techniques. Indeed, most of the patients with OP have circulating auto-antibodies (autoAb) against the epidermal side of the basement membrane zone (BMZ) with IIF using normal human salt-split skin (SSS) as substrate. Combining very sensitive techniques as IIF-SSS, immunoblotting (IB) on extracts of human keratinocyte cultures and ELISA systems up to 90% of the patients have circulating autoantibodies against the BMZ.

Publication metadata

Author(s): Carrozzo M

Publication type: Article

Publication status: Published

Journal: Oral Diseases

Year: 2006

Volume: 12

Issue: supplement 1

Pages: 1

ISSN (print): 1354-523X

ISSN (electronic): 1601-0825

Publisher: Wiley-Blackwell Publishing, Inc.


DOI: 10.1111/j.1601-0825.2006.01306_5.x

Notes: Journal Article


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