Localized bullous pemphigoid with negative immunofluorescence

We have reported two cases of localized BP without antibody or complement detectable at the BMZ. Several lines of evidence are discussed suggesting that the presence of immunoglobulin and complement at the BMZ serves as a convenient laboratory marker and does not play an etiologic role. This evidence includes the lack of production of a blister by BP serum in organ culture, the high incidence of immune complexes in BP patients, and the spontaneous increase in autoantibody in the elderly. It is suggested that autoantibody production (specifically anti-basement membrane zone antibody) may occur in BP as a marker of this disease without etiologic significance.