Epidermal cytoplasmic antibodies. (Incidence and clinical significance)

Antibodies to epidermal cytoplasmic antigens were detected by the indirect immunofluorescence (IF) technique in 36% of 100 adult healthy subjects and in 17.6% of 17 normal newborn infants. This type of autoantibody occurred in 33% of 100 cases with vitiligo, in 32.5% of 40 cases with psoriasis, in 55.3% of patients with malignant tumours and in 72.7% of subjects with malignant melanoma. The frequency of the autoimmune reactions was statistically significant only in patients with malignant neoplasms. In the majority of positive cases the IF pattern involved the upper layers of the epidermal cells (U-CYT). The basal layer was generally negative. Only a few cases showed a pattern involving both the upper and the basal layers (G-CYT). However, a wide variation in staining was noted when sera were tested on different skin specimens or different sections of the same skin. To identify the nature of the target antigen(s), absorption experiments of sera were attempted with lyophilized and particulate antigens. Animal and human blood cells and lyophilized homogenates of malignant tumours failed to absorb the autoimmune activity of positive sera. Only a powder preparation of keratin induced a decrease in antibody titres. It is postulated that they are the result of an antigenic stimulation by exogenous substances commonly present in the environment.