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ABSTRACT: INTRODUCTION Bullous pemphigoid (BP) is one of the autoimmune blister diseases. The main criteria for the diagnosis of BP are clinical features, histologic features, direct immunofluorescence test (DIF) and serologic tests to reveal autoantibodies against BP antigens, which are the structures of hemidesmosomes. Deposits of immunoglobulins and/or complement components are shown at the basement membrane zone (BMZ) in DIF of BP patients. Usually only deposits of IgG and C3 complement component are determined (1-4). Some authors determined C1q component of complement, but they did not pay attention to the significance of this problem (5). Aim The aim of the study was to assess whether determination of deposits of C1q component of complement in vivo could improve the sensitivity of DIF test in diagnosing bullous pemphigoid. Material and methods Sixty-one patients (43 women and 18 men) with BP were enrolled in the study. The patients were treated at the Wroclaw Department of Dermatology during the 2005-2008 period (4 years). DIF was routinely performed to show deposits of immunoglobulins IgG, IgA and IgM, and complement components C1q and C3c (1-3). Biopsy specimens were obtained from perilesional skin, about 1 cm from infiltrated lesion or blister. The presence of linear deposits of IgG and/or C3c and/or C1q at the BMZ was considered as positive result (1-3). Results Deposits of C3c at the BMZ in a characteristic linear pattern were found in 49 BP (80.3%) patients, being the most common type of deposit. Deposits of C1q were found in 39 (63.9%), IgG in 28 (45.9%), IgA in seven (11.5%) and IgM in 24 (39.3%) patients. Deposits of IgG were accompanied by C3c in 22 (36.1%), by C1q in 18 (29.5%) and by both C1q and C3c in 17 (27.9%) patients. Deposits of IgG and/or C3c were revealed in 55 (90.2%), IgG and/or C1q in 49 (80.3%), C1q and/or C3c in 32 (52.46%) and IgG and/or C1q and/or C3c in all patients (100.0%) (Table 1, Fig. 1). Conclusion DIF(IgG and/or C3) were positive in 90.2% BP patients. This level of sensitivity of DIF(IgG and/or C3) has been reported by other authors (1-3). Thanks to additional assessment of C1q, the new established DIF(IgG and/or C3 and/or C1q) had a significantly higher sensitivity. DIF (IgG and/or C3 and/or C1q) were positive in all patients (100%). Deposits of IgA and/or IgM were always found in the presence of other deposits (IgG and/or C1q and/or C3); therefore, determination of IgA and/or IgM did not improve the test sensitivity. Based on our experience, we suggest that C1q deposits be determined in BP patients.
Acta dermatovenerologica Croatica : ADC. 12/2011; 19(4):271-3.
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Contact Dermatitis 06/2005; 52(5):289-90. · 3.51 Impact Factor
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ABSTRACT: A case of a 62-year-old woman with recurrent subcutaneous nodules, fever and pancytopenia diagnosed as subcutaneous T-cell lymphoma is presented. Incision biopsy revealed lobular panniculitis with an inflammatory infiltrate of atypical T lymphocytes. She was treated with 7 courses of CHOP with transient remission, and she died after 17 months of disease from fatal hemorrhagic complications due to the hemophagocytic syndrome.
Acta dermatovenerologica Croatica: ADC / Hrvatsko dermatolosko drustvo 02/2004; 12(4):274-7. · 0.36 Impact Factor
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ABSTRACT: The "baboon syndrome" is a rare variant of systemic contact dermatitis and is characterized by general exanthema with particular involvement of buttocks and flexures. Here we present a 25-year-old female with contact allergy to nickel, who developed baboon syndrome after systemic administration of this allergen.
Acta dermatovenerologica Croatica: ADC / Hrvatsko dermatolosko drustvo 02/2003; 11(1):29-31. · 0.36 Impact Factor
