ABSTRACT
Advances in the immunopathology of blistering diseases now provide increased accuracy in the diagnosis of herpes gestationis in pregnancy. Guidelines are presented in this review to determine the presence of the disease. Exogenous corticosteroids will effectively alleviate symptoms and prevent formation of new lesions.
Subject(s)
Pemphigoid Gestationis/diagnosis , Pregnancy Complications/diagnosis , Skin Diseases, Vesiculobullous/diagnosis , Adult , Complement C3 , Female , Fluorescent Antibody Technique , Humans , Immunoglobulin A , Immunoglobulin G , Immunoglobulin M , Pemphigoid Gestationis/immunology , Pemphigoid Gestationis/pathology , Pregnancy , Pregnancy Complications/immunology , Pregnancy Complications/pathologyABSTRACT
The role of complement and the mechanism of sulfone action in dermatitis herpetiformis (DH) have not yet been established; prior studies have presented conflicting data regarding the effect of sulfones on complement activation and deposition. Thirty-eight DH patients were studied. Twenty-four of 25 perilesional skin biopsies and 50 of 67 normal-appearing skin biopsies showed the third component of complement (C3) deposited in areas corresponding to those of IgA deposition. Nine of 10 patients with bound C3 in normal-appearing and perilesional skin during periods of active disease continued to have C3 in normal-appearing skin when treatment with sulfones kept them completely free of lesions for 2 to 8 weeks. When either Hartley-strain or C4-deficient guinea pigs were given up to 150 mg/kg sulfoxone (a water-soluble sulfone) intraperitoneally for 8 days before elicitation of active Arthus, reverse passive Arthrus reactions, or Forssman shock, there was no difference in time course, character, or intensity of reactions when compared to saline-treated control animals. We were therefore unable to demonstrate any effect of sulfones on complement deposition in DH skin or on complement activation in classical or alternate complement pathway-mediated guinea-pig reactions.
