The epidermal basement membrane: structure, ontogeny and role in disease

Since many dermatological diseases affect the epidermal basement membrane zone (BMZ), there has been intense investigation into the role of epidermal BMZ constituents in various skin diseases, particularly subepidermal skin diseases. The epidermal BMZ consists of four major structural components--the basal cell plasma membrane, the lamina lucida, the lamina densa and the sublamina densa zone, which contains anchoring fibrils. The lamina lucida is composed of laminin, bullous pemphigoid antigen (a disease-specific glycoprotein identified by antibodies circulating in patients' sera), and other as yet poorly defined antigens which are identified by in vivo bound and circulating antibodies in the sera of patients with herpes gestationis, scarring pemphigoid and other conditions. The lamina densa consists of type IV collagen and KF-1 antigen (which is non-collagenous and is identified by a skin-specific monoclonal antibody). Knowledge of the structure and chemical composition of the BMZ is critical to an understanding of some of the genetic and immunologically mediated blistering skin diseases.