The histopathology, immunofluorescence and ultrastructure of skin in idiopathic cold-contact urticaria have been studied over the 24 h following the application of a cold stimulus sufficient to ...provoke a confluent weal on the anterior thigh. Biopsies were taken 10 min, 2 h and 24 h after ice removal. Considerable epidermal and dermal oedema was present. Type I and Type II mast-cell degranulation was noted but was not universal. Lymphatics and capillaries were dilated and endothelial cells showed an increase in micropinocytotic activity, without evident vasculitis. In two cases packed platelets were seen within vessel lumina. There was no change in the infiltrating dermal cell population and direct immunofluorescence was negative. The evidence suggests that idiopathic cold-contact urticaria is an exudative rather than an infiltrative process.
Biopsies from suction blisters raised in three normal volunteers were used as substrate in the indirect immunofluorescence technique to determine the binding site of circulating IgA antibodies in ...serum from three patients with adult linear IgA disease (LAD), nine with chronic bullous disease of childhood (CBDC), three with childhood cicatricial pemphigoid (CCP), and four with bullous pemphigoid (BP). Direct immunofluorescence was done using suction blisters raised in two patients with LAD and one with CCP. The circulating IgA antibodies in LAD and CBDC bound mainly to the roof of the blister but also to the base, and in CCP they bound only to the base of the blister. The circulating IgG antibodies in BP bound to the roof and base of the blister. These results demonstrate that the antigens in the various linear IgA dermatoses are heterogenous and are localized at different sites. The LAD and CBDC antigens are present in the lamina lucida, and the antigen in CCP is associated with the basal lamina.
Five patients with typical bullous herpes gestationis and five patients with polymorphic eruption of pregnancy were studied. Shave biopsies were taken from both involved and uninvolved skin and ...examined by routine immunofluorescence. They were also examined by immunoelectron microscopy employing a multistep peroxidase-antiperoxidase technique which has been shown to be more sensitive than immunofluorescence. Despite the increased sensitivity of immunoelectron microscopy all cases of polymorphic eruption of pregnancy were completely negative. Although there is a considerable clinical and histopathological overlap between herpes gestationis and polymorphic eruption of pregnancy our findings indicate that these conditions are pathogenetically distinct and should be classified as separate disorders.
PDF
