Delayed postburn blisters: an immunohistochemical and ultrastructural study

Abstract

This study was performed in an attempt to further elucidate the pathogenesis of delayed postburn blistering. Two cases were studied ultrastructurally and immunohistochemically, 1 with blisters on the recipient site of autologous split-thickness skin grafts and the other on the donor site. Ultrastructurally, the basement membrane was on the roof of the blisters in both cases, except for a single small blister in the first case where it was on the dermal floor. In the blister roofs, the basement membrane showed small or marked segments of discontinuity. In the adjacent non-blistered healed skin, the basement membrane was usually continuous, and anchoring fibrils were present. Immunoperoxidase staining on frozen sections, using antibodies to laminin, laminin 5, collagen IV, and collagen VII, showed a mostly continuous linear pattern in the adjacent non-blistered skin, which often became discontinuous near the blisters and markedly discontinuous in the blister roofs. In the blister floors, weakly stained linear or granular deposits of some of these components were sometimes also present. The results of this study support discontinuity of the basement membrane as the main anomaly in delayed postburn blistering. Disturbance in the reassembly or local breakdown of the basement membrane components might be the underlying defect.

New skin-equivalent model from de-epithelialized amnion membrane

“…The interaction between keratinocytes and the insoluble BM proteins contributes to the maintenance of tissue architecture and affects various biological processes, such as cell attachment, proliferation, differentiation, and migration (Blomme et al 1998;Kim et al 1994). In autologous split-thickness skin grafting for treating deep burns, a disturbance in BM reassembly is believed to be responsible for post-burn blisters (Bergman et al 1997). In conventional LSEs constructed by seeding keratinocytes on a fibroblast-populated type I collagen gel, the BM is not well developed a few weeks after airlifting and is rarely seen after their transplantation onto nude mice (Amano et al 2001;Medalie et al 1997).…”

Dyskeratosis as a histologic feature in epidermolysis bullosa simplex-Dowling Meara

“…The other biopsy specimen was processed for electron microscopy as previously described. 10 The histopathologic slides of all 4 cases were scrutinized carefully in a nonblinded manner for histopathologic clues to the electron microscopic demonstration of tonofilament aggregation. In addition, the histologic slides of 11 non-EBS-DM cases including 9 EBS-WC subtype cases and two EBSKoebner subtype cases aged 7 days to 69 years (average 15 years) were retrieved from the pathological files and examined for similar histologic features.…”

Recalcitrant Caustic Burn Wound and Definitive Treatment with Medial Plantar Flap

“…Discontinuity of the basement membrane is assumed as the main anomaly due to the dis- turbance in the reassembly or local breakdown of the basement membrane components in delayed post-burn blistering. [7] Minor traumas such as rubbing or friction is also some other etiologic factors for blistering. [8] In either etiology, graft lysis due to delayed blistering is rarely reported at the transplantation sites of autologous split thickness skin grafts after full take.…”

“…[8] In either etiology, graft lysis due to delayed blistering is rarely reported at the transplantation sites of autologous split thickness skin grafts after full take. [7] Likewise, blistering of the skin graft after caustic burn is also rare. [5,9] To the best of our knowledge, repeated episodes of blistering and necrosis following alcali burn is reported only for one case in a long term follow-up period.…”