Ultrastructural aspects of dermatitis herpetiformis (Duhring's disease).

Abstract

Summary.— Biopsies of clinically normal skin and erythematous and recent vesicular lesions of 3 patients with dermatitis herpetiformis (DH) were studied by electron microscopy. The early events at the dermo–epidermal junctional zone were the presence of glycogen and lipid particles in the basal cells, rarefaction of half‐desmosomes, and small duplications of the basal lamina. In some areas of the dermo‐epidermal junction of the erythematous skin separation between epithelial basal cells and basal lamina was observed. In the vesicles fibrin, with its typical cross‐banding pattern, was seen. The early changes observed in the epithelial germinative cells were interpreted as evidence of disturbance in dermo‐epidermal interaction, possibly caused by immunoglobulin deposition at this level. The abnormal synthesis of half‐desmosomes by the basal cells could be the cause of supra‐laminar dis‐junction.