A thorough work-up is paramount in the accurate diagnosis of oral erosive diseases.
Objective:
A case of pemphigoid with negative direct immunofluorescence but positive indirect immunofluorescence is presented.
Methods and Results:
A 77-year-old man presented with erosions of the oral and glans mucosa and with esophageal stenosis. Histologic examination revealed nonspecific mucositis. Indirect immunofluorescence was characteristic of pemphigoid.
Conclusion:
This case illustrates the importance of performing a complete diagnostic work-up in the evaluation of patients with oral erosive disease.
MutasimDFPelcNJSupapannachartN. Established methods in the investigation of bullous diseases. Dermatol Clin1993; 11:399–418.
7.
BernardPProstCDurepaireN. The major cicatricial pemphigoid antigen is a 180 kD protein that shows immunologic cross-reactivities with the bullous pemphigoid antigen. J Invest Dermatol1992; 99:174–179.
8.
DanielsTEQuadra-WhiteC. Direct immunofluorescence in oral mucosal disease: A diagnostic analysis of 130 cases. Oral Surg1981;51:38–47.
MeyerJRMiglioratiCADanielsTEGreenspanJS. Localization of basement membrane components in mucous membrane pemphigoid. J Invest Dermatol1985; 84:105–107.
12.
LaskarisGAngelopoulosA. Cicatricial pemphigoid: Direct and indirect immunofluorescent studies. Oral Surg Oral Med Oral Pathol1981; 51:48–54.
13.
TagamiHImamuraS. Benign mucous membrane pemphigoid: Demonstration of circulating and tissue-bound membrane antibodies. Arch Dermatol1974; 109:711–713.
14.
KormanNJWatsonRD. Immune-mediated subepithelial blistering diseases of the mucous membranes: Improving the detection of circulating autoantibodies by the use of concentrated serum samples. Arch Dermatol1996; 132:1194–1198.
