Ultrastructural and immuno-electron microscopic study in a case of epidermolysis bullosa acquisita

Skin biopsies from a patient with epidermolysis bullosa acquisita (EBA) were studied ultrastructurally and by immuno-electron microscopy. The specimens were taken from non-predilection areas as well as of the skin predilection areas of the patient. In vivo deposits of IgG were found below the lamina densa associated with the anchoring fibrils in all areas of the skin. The bullae and the artificial friction blisters appeared in the same position on the dermal side of lamina densa. The results suggest that epidermolysis bullosa acquisita is a distinct nosologic entity. The close resemblance of epidermolysis bullosa acquisita to cicatricial pemphigoid in immunofluorescence studies makes the use of immuno-electron microscopy important in the classification of the diseases.