Ultrastructural Findings in Bullous Pemphigoid

In four bullous pemphigoid patients electron microscopic and direct immunofluorescence examinations were carried out on sections of the border of a blister, apparently normal skin surrounding the blister, apparently normal skin distant from the blister, and apparently normal skin subjected to the stimulus of a xenon lamp. The bullous pemphigoid blister was formed by cleavage of the basal cells away from the basal lamina which remained intact. The intercellular spaces were widened and the half-desmosomes reduced in number in the skin surrounding the blister. Xenon lamp irradiation produced a pattern similar to that of the skin surrounding the blister, but without immunoglobulins and complement fixed in vivo.