Ultrastructural immunocytochemistry of autoimmune bullous diseases

Advanced immunopathological assays have been developed to elucidate the pathophysiology and provide more precise nosological definitions of the immunobullous diseases. Forty-seven patients suffering from autoimmune bullous diseases (intra- or subepidermal) were studied by immunoelectron microscopy (direct and indirect). Peroxidase staining was revealed by diaminobenzidine (determination of immune deposit location) in the majority of the cases of subepidermal bullous diseases, but in less than half of the cases of intraepidermal bullous diseases. Immunoelectron microscopy features contributed in verifying the diagnosis of rare entities such as cicatricial pemphigoid, paraneoplastic autoimmune bullous disease, linear IgA disease and epidermolysis bullosa acquisita.