Dermal-epidermal junction in lupus erythematosus

The dermal-epidermal zone, a primary site of injury in cutaneous lupus erythematosus (LE), has been examined by light, fluorescent, and electron microscopy. Immunoglobulins were present at the dermal-epidermal zone in 92% of systemic lupus erythematosus (SLE) lesions, 90% of discoid lupus erythematosus (DLE) lesions, 60% of uninvolved SLE skin, and absent in uninvolved DLE skin. Circulating "basement membrane" antibodies were not noted in LE sera. Antibodies to epidermal nuclei were present in 77% SLE sera and 39% DLE sera. Apparent thickening of the hematoxylin and eosin and PAS basement membrane is frequently seen. Electron microscopy of 13 specimens demonstrated that this finding was associated with intricate projections and infoldings of basal cells and dermis. Necrosis and disintegration of the dermal-epidermal zone was noted.