Klein G F, Hintner H, Schuler G, Fritsch P
Br J Dermatol. 1983 Nov;109(5):499-508. doi: 10.1111/j.1365-2133.1983.tb07671.x.
The level of cleavage was determined in a variety of acquired bullous diseases of the dermal-epidermal junction zone (bullous pemphigoid, dermatitis herpetiformis, porphyria cutanea tarda and epidermolysis bullosa acquisita). We used an indirect immunofluorescence technique to examine the basal membrane zone with anti-type IV collagen and anti-laminin antisera and bullous pemphigoid sera. The majority of blisters examined proved to be junctional, including those from disorders hitherto considered to be dermolytic. Dermolytic cleavage was encountered only sporadically in microvesicles of dermatitis herpetiformis, in one small vesicle and in one out of five large blisters of porphyria cutanea tarda and in a large lesion of epidermolysis bullosa acquisita. We conclude that in acquired bullous disorders of the dermal-epidermal junction zone the preferential site of split formation is the lamina lucida which appears to act as a locus minoris resistentiae; dermolytic split formation of substantial extent occurs only when the sublaminal fibrillar apparatus is mechanically compromised.
在多种获得性真皮-表皮交界区大疱性疾病（大疱性类天疱疮、疱疹样皮炎、迟发性皮肤卟啉病和获得性大疱性表皮松解症）中确定了裂隙形成的水平。我们使用间接免疫荧光技术，用抗IV型胶原和抗层粘连蛋白抗血清以及大疱性类天疱疮血清检查基底膜带。大多数检查的水疱被证明是交界性的，包括那些来自迄今被认为是皮肤松解性疾病的水疱。仅在疱疹样皮炎的微泡中偶尔遇到皮肤松解性裂隙，在迟发性皮肤卟啉病的一个小水疱和五个大水疱中的一个以及在获得性大疱性表皮松解症的一个大病变中遇到。我们得出结论，在获得性真皮-表皮交界区大疱性疾病中，裂隙形成的优先部位是透明板，它似乎起到了阻力较小的部位的作用；只有当板下纤维装置受到机械损伤时，才会发生实质性的皮肤松解性裂隙形成。
