Immunoglobulin deposits in the epidermis of patients with primary Sjögren's syndrome. A consecutive study

In biopsies from macroscopically healthy skin, IgG deposits were demonstrated in the intercellular areas of the epidermis by a direct immunofluorescence technique, in 17 of 25 consecutive patients with primary Sjögren's syndrome. Intercellular epidermal deposits of IgA were found in 4 and of IgM in 1 of the 25 patients. Deposits of IgG in the dermal blood vessel walls were found in 9 patients, IgA in 1 and IgM in 3 patients. In 3 of 23 patients with secondary Sjögren's syndrome intercellular IgG deposits were found in the epidermis, and in 2 of these 3 patients IgA deposits were likewise demonstrated. No immunoglobulin deposits were found in the dermo-epidermal junction zone in patients with primary and secondary Sjögren's syndrome. No deposits of immunoglobulin were found intercellularly in epidermis or in dermal blood vessel walls in 23 sex and age matched healthy controls. Blood samples obtained simultaneously from all patients and controls showed no correlation of serum IgG levels with deposits in the skin. We conclude that investigation for IgG deposits in the intercellular area of the epidermis and/or in the dermal vessel walls in macroscopically healthy skin may be of diagnostic help in patients with chronic inflammatory connective tissue disease.