-
Frontiers in Immunology 2022Pemphigoid diseases (PD) are autoimmune skin blistering diseases characterized by autoantibodies directed against proteins of the cutaneous basement membrane zone (BMZ).... (Review)
Review
Pemphigoid diseases (PD) are autoimmune skin blistering diseases characterized by autoantibodies directed against proteins of the cutaneous basement membrane zone (BMZ). One of the major antigens is type XVII collagen (BP180), a transmembrane glycoprotein, which is targeted in four PDs: bullous pemphigoid, mucous membrane pemphigoid, linear IgA dermatosis, and pemphigoid gestationis. To date, different epitopes on BP180 have been described to be recognized by PD disease patients' autoantibodies. Different BP180 epitopes were associated with distinct clinical phenotypes while the underlying mechanisms are not yet fully understood. So far, the main effects of anti-BP180 reactivity are mediated by Fcγ-receptors on immune cells. More precisely, the autoantibody-antigen interaction leads to activation of complement at the BMZ and infiltration of immune cells into the upper dermis and, by the release of specific enzymes and reactive oxygen species, to the degradation of BP180 and other BMZ components, finally manifesting as blisters and erosions. On the other hand, inflammatory responses independent of Fcγ-receptors have also been reported, including the release of proinflammatory cytokines and internalization and depletion of BP180. Autoantibodies against BP180 can also be found in patients with neurological diseases. The assumption that the clinical expression of PD depends on epitope specificity in addition to target antigens, autoantibody isotypes, and antibody glycosylation is supported by the observation that epitopes of PD patients differ from those of PD patients. The aim of the present review is to describe the fine specificities of anti-BP180 autoantibodies in different PDs and highlight the associated clinical differences. Furthermore, the direct effects after binding of the autoantibodies to their target are summarized.
Topics: Autoantibodies; Autoantigens; Autoimmune Diseases; Carrier Proteins; Complement System Proteins; Epitopes; Humans; Immunoblotting; Nervous System Diseases; Non-Fibrillar Collagens; Pemphigoid, Bullous; Receptors, IgG; Collagen Type XVII
PubMed: 36032160
DOI: 10.3389/fimmu.2022.948108 -
American Family Physician Nov 2010Nongenital herpes simplex virus type 1 is a common infection usually transmitted during childhood via nonsexual contact. Most of these infections involve the oral mucosa...
Nongenital herpes simplex virus type 1 is a common infection usually transmitted during childhood via nonsexual contact. Most of these infections involve the oral mucosa or lips (herpes labialis). The diagnosis of an infection with herpes simplex virus type 1 is usually made by the appearance of the lesions (grouped vesicles or ulcers on an erythematous base) and patient history. However, if uncertain, the diagnosis of herpes labialis can be made by viral culture, polymerase chain reaction, serology, direct fluorescent antibody testing, or Tzanck test. Other nonoral herpes simplex virus type 1 infections include herpetic keratitis, herpetic whitlow, herpes gladiatorum, and herpetic sycosis of the beard area. The differential diagnosis of nongenital herpes simplex virus infection includes aphthous ulcers, acute paronychia, varicella-zoster virus infection, herpangina, herpes gestationis (pemphigoid gestationis), pemphigus vulgaris, and Behçet syndrome. Oral acyclovir suspension is an effective treatment for children with primary herpetic gingivostomatitis. Oral acyclovir, valacyclovir, and famciclovir are effective in treating acute recurrence of herpes labialis (cold sores). Recurrences of herpes labialis may be diminished with daily oral acyclovir or valacyclovir. Topical acyclovir, penciclovir, and docosanol are optional treatments for recurrent herpes labialis, but they are less effective than oral treatment.
Topics: Administration, Oral; Antiviral Agents; Herpes Simplex; Herpesvirus 1, Human; Humans; Seroepidemiologic Studies; United States
PubMed: 21121552
DOI: No ID Found -
Acta Medica Portuguesa Nov 1994
Review
Topics: Adult; Diagnosis, Differential; Female; Humans; Pemphigoid Gestationis; Pregnancy; Pregnancy Outcome
PubMed: 7717102
DOI: No ID Found -
Turk Patoloji Dergisi 2014Pemphigoid gestationis is a rare vesiculobullous dermatosis of pregnancy and puerperium. It is commonly seen in second or third trimester. Skin lesions are characterized...
Pemphigoid gestationis is a rare vesiculobullous dermatosis of pregnancy and puerperium. It is commonly seen in second or third trimester. Skin lesions are characterized by pruritic, urticarial plaques with the development of tense vesicles and bullae. Histopathology demonstrates a subepidermal eosinophil-rich vesiculation. Direct immunofluorescence microscopy reveals linear complement 3 and immunoglobulin G deposition along the basement membrane. We present a rare case of pemphigoid gestationis occurring in a 33-year-old pregnancy woman with symptom of generalized pruritis. Pemphigoid gestationis should be kept in mind in the differential diagnosis of vesiculobullous dermatitis of pregnancy.
Topics: Adult; Female; Fluorescent Antibody Technique; Humans; Pemphigoid Gestationis; Pregnancy
PubMed: 24101351
DOI: 10.5146/tjpath.2013.01172 -
Journal of Obstetrics and Gynaecology... Dec 2014
PubMed: 25404796
DOI: 10.1007/s13224-013-0408-0 -
Australian Journal of General Practice Dec 2021Women with rashes or itchy skin during pregnancy will often present initially to the general practitioner. Knowledge of the specific dermatoses of pregnancy...
BACKGROUND
Women with rashes or itchy skin during pregnancy will often present initially to the general practitioner. Knowledge of the specific dermatoses of pregnancy will assist in diagnosis, management and, importantly, facilitation of timely escalation of care of conditions that can potentially affect the fetus.
OBJECTIVE
The aim of this article is to provide a diagnostic framework for approaching a pruritic rash during pregnancy as well as a helpful summary of management of pregnancy-specific dermatoses. It will assist clinicians in the identification of specific dermatoses that pose fetal risks.
DISCUSSION
In addition to considering non-pregnancy specific conditions when approaching pruritus or a pruritic rash in pregnancy, it is important that clinicians also consider pregnancy-specific dermatoses, which have been reclassified into four categories: polymorphic eruption of pregnancy, pemphigoid gestationis, intrahepatic cholestasis of pregnancy (ICP) and atopic eruption of pregnancy. Unlike the other dermatoses, ICP begins with pruritus, and skin changes are secondary. ICP and pemphigoid gestationis are associated with fetal risks such as prematurity and stillbirth.
Topics: Cholestasis, Intrahepatic; Female; Humans; Pemphigoid Gestationis; Pregnancy; Pregnancy Complications; Pruritus; Skin Diseases
PubMed: 34845477
DOI: 10.31128/AJGP-03-21-5900 -
The Journal of Investigative Dermatology Jul 1984
Topics: Female; HLA-DR Antigens; Histocompatibility Antigens Class II; Humans; Male; Pemphigoid Gestationis; Pregnancy; Pregnancy Complications; Skin Diseases, Vesiculobullous
PubMed: 6376644
DOI: 10.1111/1523-1747.ep12261828 -
Case Reports in Obstetrics and... 2014Pemphigoid gestationis (PG) is a rare vesiculobullous dermatosis of pregnancy. It is commonly seen in second or third trimester. The diagnosis is frequently made with...
Pemphigoid gestationis (PG) is a rare vesiculobullous dermatosis of pregnancy. It is commonly seen in second or third trimester. The diagnosis is frequently made with direct immunofluorescence studies of perilesional skin. Prompt recognition and appropriate management may reduce morbidity of this disease. Herein we present a case of pemphigoid gestationis occurring in a 33-year-old primigravida woman with symptoms of generalized pruritus.
PubMed: 25431712
DOI: 10.1155/2014/127628 -
Indian Journal of Dermatology 2008The skin changes in pregnancy can be either physiological (hormonal), changes in pre-existing skin diseases or development of new pregnancy specific dermatoses....
The skin changes in pregnancy can be either physiological (hormonal), changes in pre-existing skin diseases or development of new pregnancy specific dermatoses. Pregnancy-specific skin dermatoses include an ill-defined heterogeneous group of pruritic skin eruptions which are seen only in pregnancy. These include atopic eruption of pregnancy, polymorphic eruption of pregnancy, pemphigoid gestationis and intrahepatic cholestasis of pregnancy. Atopic eruption of pregnancy is the most common of these disorders. Most skin eruptions resolve postpartum and require only symptomatic treatment. Antepartum surveillance is recommended for patients with pemphigoid gestationis and intrahepatic cholestasis of pregnancy as they carry fetal risk. This article deals with the classification, clinical features and treatment of the specific dermatoses of pregnancy.
PubMed: 19882004
DOI: 10.4103/0019-5154.43203 -
The Journal of Clinical Investigation Jul 1973A patient with herpes gestationis, 6 of 6 patients with bullous pemphigoid, and 5 of 25 patients with systemic lupus erythematosus were found to have properdin deposited...
A patient with herpes gestationis, 6 of 6 patients with bullous pemphigoid, and 5 of 25 patients with systemic lupus erythematosus were found to have properdin deposited along the skin basement membrane.The patient with herpes gestationis demonstrated by immunofluorescence basement membrane deposition of C3 and C5 in the absence of C1q, immunoglobulins, and light chains. A second patient with herpes gestationis had C3 deposition with no demonstrable immunoglobulins or light chains. A thermolabile humoral factor(s) capable of depositing C3 (without C1q or C4) on normal skin basement membrane was found in the sera of both patients with herpes gestationis. No anti-basement membrane antibodies could be demonstrated in the sera of these patients.The patients with systemic lupus erythematosus and bullous pemphigoid who manifested properdin deposition also showed skin basement membrane deposits of C1q, C4, C3, C5, and immunoglobulins. C3 proactivator (C3PA) was also found deposited along the skin basement membrane of three patients with systemic lupus erythematosus and all six bullous pemphigoid patients. This study provides suggestive evidence that activation of complement is occurring via the alternate pathway in herpes gestationis. In systemic lupus erythematosus and bullous pemphigoid, both the classical (antibody) mediated activation of complement as well as the alternate pathway may be operative.
Topics: Adult; Antibody Specificity; Basement Membrane; Complement System Proteins; Female; Fluorescent Antibody Technique; Herpesviridae Infections; Humans; Immunoglobulins; Lupus Erythematosus, Systemic; Pregnancy; Properdin; Skin; Skin Diseases
PubMed: 4352464
DOI: 10.1172/JCI107359