Cutaneous Lupus Erythematosus: Direct Immunofluorescence and Epidermal Basal Membrane Study

Abstract

Biopsy specimens of cutaneous discoid lesions of 71 patients with cutaneous lupus erythematosus (CLE) were studied. The material was examined by direct immunofluorescence (DIF) to establish positivity and morphologic patterns of immunoglobulins and complement deposits in the basement membrane zone (BMZ). A correlation between DIF results and thickening of the epidermis basement membrane (BM) stained by periodic acid-Schiff (PAS), obtained from 31 matched biopsy specimens, also is presented. Direct immunofluorescence had positive results in 66.20% of the 71 examinations and 70.97% of the matched examinations, whereas PAS showed BM thickening in 100% of the specimens. This observation stresses the importance of such histopathologic findings in the diagnosis of discoid lesions in CLE. There was no correlation between DIF patterns and PAS-stained BMZ thickening. These findings merit additional study. In conclusion, an accordance between PAS-stained BM thickening and immunoglobulin deposits has occurred in 70.97% of cases. This phenomenon does not depend on the presence of immunocomplexes, for it occurs even in cases in which immunocomplex deposits were not detected.

Lupus-Like Histopathology in Bloom Syndrome: Reexamining the Clinical and Histologic Implications of Photosensitivity

“…27 This is the first report of BM thickening in a patient with BS. The finding of BM thickening is specific and suggests chronic interface injury, therefore atypical of BS.…”

Cicatricial alopecia; a dermatopathologic and immunopathologic study of 33 patients (pseudopelade of brocq is not a specific clinico‐pathologic entity)

“…When discussing immunopathology in scarring alopecias it should be stressed that immunopathological findings documented only by DIF cannot be considered by themselves always diagnostic. However, in DLE, Ig and complement deposits at the DEJ in the lesional skin are very characteristic particularly if the pattern of staining observed (variously described as granular, thready, fibrillar) is very thick 21–30 . Furthermore, in DLE lesional skin globular deposit (fluorescent or ovoid bodies) are usually localized immediately beneath the DEJ with linear arrangement, whereas in LPP they often occur in groups or clumps 31,32 , 33,34 , 35 .…”

Special Stains and Immunohistochemical Stains in Hair Pathology

“…7,8 In one controlled study, it was found that all 31 cases of DLE showed basement membrane thickening compared with none in the group of matched controls. 7 The pattern was segmental or focal and correlated with positive direct immunofluorescence in 71% of the cases. Basement membrane thickening corresponds to duplication of the basal lamina and occurs due to inflammation or immunocomplex deposition.…”