Cicatricial pemphigoid: direct and indirect immunofluorescent studies.

Oral mucosa, skin tissue, and serum samples from thirty-three patients with cicatricial pemphigoid were studied by the direct and indirect immunofluorescent techniques to determine the presence of tissue-bound and circulating antibodies. A linear continuous basement membrane zone pattern was observed in 96.9 percent of the oral mucosa biopsy specimens studied. This pattern is indistinguishable from the pattern observed in bullous pemphigoid. In 97 percent of the cases clinically healthy skin biopsy specimens were negative for basement membrane zone staining. Circulating anti-basement membrane zone antibodies were present in 36.4 percent of thirty-three patients with cicatricial pemphigoid in low titer (1:10 to 1:40), when normal oral mucosa was used as substrate. The demonstration of tissue-bound and circulating basement membrane zone antibodies in cicatricial pemphigoid morphologically identical to those found in bullous pemphigoid provides further support for the concept that the two diseases may represent variants of the same entity.