Immunohistochemical findings in a patient with penicillamine pemphigus

Abstract

This report describes the immunofluorescence (IF) findings in sequential skin biopsies and serum obtained during a follow-up study of a patient who developed pemphigus lesions after D-penicillamine treatment of arthritis. The distribution in the skin of IgG, IgM and C3 varied with the date, type and site of the biopsy sample. Thus IF patterns showed features of (a) pemphigus vulgaris, (b) pemphigus foliaceus and (c) pemphigus erythematosus. Indirect IF examination indicated the presence of circulating intercellular epithelial antibody of both the IgG and IgM class.

Detection of immune deposits in skin lesions of patients with Wegener's granulomatosis

“…Biopsies were taken and stained according to a previously described protocol18 19 with minor modifications. In short, after local anaesthesia with lidocain (lignocaine), a 3–4 mm punch biopsy was obtained from a skin lesion within 48 hours of development of the lesion.…”

Pemphigus superficiel apparu lors du traitement d’une polyarthrite rhumatoïde par <i>D</i><i>-</i>pénicillamine et piroxicam (Feldène^®)

“…L'immunofluorescence directe marque les espaces intercellulaires dans la majorité des cas [De Jong et al, 1980]. L'immuno fluorescence indirecte met en évidence, dans 75% des cas rapportés, des taux peu élevés d'anticorps antisubstance intercellulaire; notre patient par contre présente un taux élevé, inhabituel, de ces anticorps à 1/2500.…”

Induction of auto-immune syndromes by penicillamine therapy in rheumatoid arthritis and other diseases

“…Most of the subsequent reports have been in RA patients, which reflects the greater use of the drug in treatment of that disorder [30,53,813. The literature refers to pemphigus vulgaris [373, pemphigus foliaceus [-56], and pemphigus erythematosus [30], in relation to penicillamine therapy. Serial immunohistochemical studies have shown that in the evolution of this disease by sequential biopsies, features of all of the forms of pemphigus may be observed [303.…”

“…Biopsy of the cutaneous bullae shows intraepidermal acantholysis with intercellular deposits of immunoglobulin [11]. Indirect immunofluorescence to detect serum antibody against intercellular cement substance has been positive in about 70~ of the cases [30]. In a recently studied case, the immunofluorescent findings were those of bullous pemphigoid, with immunoglobulin deposition at the dermal-epidermal junction and circulating antibody directed to the basement zone [87].…”