[Immunopathology of dermatitis herpetiformis and bullous pemphigoid (author's transl)]

Abstract

Dermatitis herpetiformis and bullous pemphigoid are similar enough clinically to have been considered for some time as two forms of the same disease. Their histologic and ultrastructural characteristics are a more accurate mean of differenciation: employed essentially with respect to early lesions and the mode of bullous formation. But immunologic analysis is especially helpful in distinguishing the two. This study involves the analysis of acquired data concerning these two entities: 1) The nature, form, and topography of immunoglobulin and complement deposits examined under the light microscope and by immuno-electron microscopy methods. 2) Other modifications of he immunologic status of affected subjects. 3) The supposed nature of causative antigens. 4) The suggested pathogenic mechanisms. There exist discrepancies in the information at hand concerning these domains: the most important number of latest data relate to DH and notably: - The relationship between DH and gluten sensitive enteropathy for which are considered the clinical, histologic, immunologic characteristics and the relationship of this enteropathy with celiac sprue disease, the role of a gluten free diet on skin lesions and immune deposits. - The relationship between DH and specific histocompatible antigens. The data has revealed some important perspectives on the pathogenesis of these bullous skin lesions.