HERPETIFORM PEMPHIGUS, A VARIABLE PATTERN OF PEMPHIGUS

ABSTRACT: A patient with the clinical features of dermatitis herpetiformis and the histological features of pemphigus, subcorneal dermatosis and dermatitis herpetiformis did not respond to treatment with pyridine or sulfones. Systemic steroids and azothioprine were effective. Immunofluorescence studies demonstrated circulating pemphigus antibodies and IgG bound in vivo in the intercellular spaces of the epidermis.     

DIAGNOSIS OF PEMPHIGUS

SUMMARY.— Differentiation of the pemphigus group of diseases from other bullous dermatoses is established by (1) blister spreading. (2) immuno-fluorescence, (3) general clinical and pathological criteria.
Differentiation between the pemphigus diseases: pemphigus vulgitris, vegetans, foliaceus, erythematosus, chronicus and conjunctivae is established by (1) site of artificial bulla after spreading. (2) acantholysis. (3) site of fluorescent antibody binding, (4) specific clinical and pathological criteria.     

PEMPHIGUS IN EL SALVADOR

Of 23 patients with pemphigus seen between 1970 and 1977, 18 had foliaceus and five had vulgaris (ratio of 3.73:1). The characteristics of pemphigus foliaceus (age of onset, disease among sisters, presence of lesions resistant to corticotherapy) suggest Brazilian pemphigus foliaceus (fogo selvagem).     

COSMETIC CAMOUFLAGE IN DERMATOLOGY

Summary.— This paper advocates and illustrates the use of a camouflage clinic for patients with embarrassing skin blemishes, especially where severe psychological stress has resulted. The staff of such a clinic should have special training in the techniques employed.     

Clq-BINDING SUBSTANCES IN PEMPHIGUS

Serial serum samples from sixteen patients with pemphigus were assayed for Clq binding activity (ClqBA) using a modified solid phase Clq binding assay. The modification included use of horseradish peroxidase instead of ¹²⁵I or ¹³¹I. ClqBA was detected in six of the sixteen patients. Sequential samples from those positive patients demonstrated a decrease in ClqBA in response to steroid therapy.     

EXTRACTION OF PEMPHIGUS ANTIBODIES FROM A LYMPHOID NEOPLASM AND ITS POSSIBLE RELATIONSHIP TO PEMPHIGUS VULGARIS

Summary.— A patient is described who had a malignant lymphoid neoplasm and later developed pemphigus vulgaris. Tumour homogenate from the neoplasm contained a high titre of pemphigus antibodies.