Immunopathological studies in a mixture of pemphigus and pemphigoid - abstract

This is the first report from the Commonwealth Caribbean of a mixture of two rare forms of vesiculobullous diseases. A mixture of both bullous pemphigoid and pemphigus vulgaris was present in a 61 year-old East Indian man. He presented at the Dermatology Clinic of the Port-of-Spain Hospital with vesiculobullous lesions of both the tense and flaccid types extending throughout his trunk, limbs and face. Skin biopsies showed both immunoglobulin and complement at the intercellular spaces of the epidermis of the flaccid bulla and at the basement membrane zone (BMZ) from the tense bulla supporting the existence of both pemphigus and pemphigoid but the fourth confirmed the above findings. This patient gave a favourable clinical response to corticosteroid therapy with the disappearance of pemphigus antibodies but the anti-BMZ antibodies (typical of pemphigoid) persisted, as expected. It is clear from these findings that immunopathological investigations are not only essential in the early diagnosis of these rare bullous forms but also in prognosis (AU)