Several skin diseases may present as vesicles or bullae. Immunofluorescent studies arc very helpful in differentiating the various disea.sc entities. Familiarity with the procedure and the various kinds of patterns that are specific and non-specific is essential for the practicing dermatologist. Immunofluorescent patterns are particularly helpful in differentiating pemphigus, bullous pemphigoid. cicatrical pcmphigoid. herpes gcstaliottis, dertttatitis hetpetifortttis, linear IgA derniatosis and porphyria. ImniunofluorcscenI studies of the skin and sera of these patients were vital to an understanding their pathogenesis. Immunoelcetron microscopy has further helped in delineating the exact sites of immunoglobulin deposition, and. thus, identifying the location of the antigens. In pemphigus, studies at the molecular level reveal thai the basic pathological process is mediated by an anti-cellular cement substance antibody. The binding of this antibody at the cell surface level results in a process Ihal is seen at the lighl microscopy level in the form of acantholysis. In bullous pcmphigoid cells may play an important role, tt appears ihat the mast cell, cosinophil. and the lymphocyte in harmony with the polymorplioiiuclcar leucocyte work together to bring about an enzymatic degradation of Ihc basement membrane. The specilic role of the anti-basement membrane zone antibody is also under current study. With advances in molecular immunology, especially monoclonal antibodies and gene technology, it is hoped that these cellular and molecular interactions will be better understood and further defined. February 21, 1984 In this review. I shall bnefly outline the pnn-"..,"" .
Accepted for ptthlication, Principles of fluorescent niicro.scopv ciples of lmmunofluorescence microscopy and use of tbis technique in the diagito.sis of bull-The knowledge, understanding and interous disease. The role of immunopathology in pietalion of ctitaneous immttnonttorescence the advancement of understanding the patho-arc no longer eonfined to tfte histopathologist genesis of blister formation will then be dis-or lo the realms of research, but it is a procussed in detail.eedure thai should be tinderstood by the piae-16 Cutaneous P;t(hoi<)gy il; 4