Ultrastructural Aspects of Mucosas in Endemic Pemphigus Foliaceus

Vulvo-cervico-vaginal manifestations and evaluation of Papanicolaou smears in pemphigus vulgaris and pemphigus foliaceus

“…Possible explanations for this finding are either epitope spreading (shift from PF to PV in progression) or ultrastructural changes in the uterine cervix preceding acantholysis. 19 Relevant findings of this study include: vulvar lesions were the second most frequent site of PV mucosal involvement; symptomatic genital involvement (especially vulvar) may be a PF clinical presentation; gynecologic evaluation of patients with pemphigus should be performed; and a careful evaluation of Pap smears in patients with pemphigus is needed to avoid misdiagnosis and potentially drastic clinical consequences (eg, hysterectomy).…”

Large-Scale Electron Microscopy Maps of Patient Skin and Mucosa Provide Insight into Pathogenesis of Blistering Diseases

“…Intercellular widening is defined as 40.5 μm gap between two neighboring cells, which are still in contact. Until recently, this widening was considered to be the first evidence of acantholysis; however, it is also present in basal and suprabasal layers of the skin and mucosa of PF patients where acantholysis is absent (Guedes et al, 2002;Oktarina et al, 2011;van der Wier et al, 2012). Thus, nonjunctional Dsg1 apparently is, in a yet-to-be uncovered way, important for interdesmosomal cohesion as loss is associated with widening.…”

Subclinical oral involvement in patients with endemic pemphigus foliaceus

“…Other authors studied patients with FS and 4 control subjects, examining the oral mucosa using electron microscopy. In addition to showing clinically normal oral mucosa, electron microscopy showed widening of the intercellular spaces between keratinocytes [ 6 – 11 ].…”

“…Previous studies have shown that patients affected by EPF in Brazil have some oral findings [ 7 , 8 ]. Selected authors have described the presence of autoantibodies using hematoxylin and eosin (H&E) staining, direct and indirect immunofluorescence (DIF, IIF), and electron microscopy studies [ 9 – 11 ]. In the current study, our aim was to search for oral clinical lesions and an oral autoimmune response in patients affected by EPF in El Bagre, Colombia (El Bagre-EPF) [ 1 – 5 ] and to compare our findings with those described in the medical literature for Brazilian EPF patients.…”