Epstein A, Hendrick S J, Sanchez R L, Solomon A R, Fine J D
Department of Dermatology, University of Texas Medical Branch, Galveston.
Arch Dermatol. 1988 Feb;124(2):244-9.
We describe a child who began developing subepidermal blisters in the recipient sites of split-thickness skin grafts; this process has continued for almost a year and continues to spare nongrafted skin. Routine histologic and immunofluorescence mapping studies demonstrated this disorder to be a relatively noninflammatory one characterized by sub-lamina densa blister formation. Results of direct immunofluorescence were negative. By electron microscopy, anchoring fibrils were sparse in number and in some areas appeared malformed; otherwise, the basement membrane zone was morphologically unremarkable. Bullous pemphigoid antigen, laminin, type IV collagen, epidermolysis bullosa acquisita antigen, and LDA-1 were all normally expressed along the dermoepidermal junction. In contrast, KF-1 antigen was absent. These findings suggest a disease process confined to skin graft recipient sites with features identical to those previously described with recessive dystrophic or immunofluorescence-negative acquired epidermolysis bullosa.
我们描述了一名儿童，其在中厚皮片移植的受区开始出现表皮下水疱；这一过程已持续近一年，且未移植皮肤未受累。常规组织学和免疫荧光定位研究表明，这种疾病相对无炎症，其特征为致密板下疱形成。直接免疫荧光结果为阴性。通过电子显微镜检查，锚原纤维数量稀少，在某些区域呈畸形；除此之外，基底膜带在形态上无明显异常。大疱性类天疱疮抗原、层粘连蛋白、IV型胶原、获得性大疱性表皮松解症抗原和LDA - 1在真皮表皮交界处均正常表达。相比之下，KF - 1抗原缺失。这些发现提示一种局限于皮肤移植受区的疾病过程，其特征与先前描述的隐性营养不良型或免疫荧光阴性的获得性大疱性表皮松解症相同。
