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November 26, 1982

Vesiculobullous Skin Diseases With Prominent Immunologic Feature

JAMA. 1982;248(20):2623-2626. doi:10.1001/jama.1982.03330200047012

IN 1964, Beutner and Jordon reported that serum specimens of patients with pemphigus contained antibodies against the epidermal cell surface, the site of earliest histopathologic change. This finding stimulated subsequent studies that improved the therapeutic approaches to these diseases. In this section the following vesiculobullous disorders are discussed: pemphigus vulgaris, bullous pemphigoid, cicatricial pemphigoid, herpes gestationis, dermatitis herpetiformis, and benign chronic bullous dermatosis of childhood.

PEMPHIGUS VULGARIS  Pemphigus vulgaris is a chronic bullous disease that occurs in all races and ethnic groups. It has been reported in association with thymoma, myasthenia gravis, and systemic lupus erythematosus. Before the availability of corticosteroid and antibiotic drugs, the disease was often fatal because of fluid and electrolyte abnormalities, cachexia, and sepsis secondary to the denudation of large areas of skin.The disorder is characterized by thin, flaccid bullae on normal-appearing skin. The mucous membranes are commonly involved and are often the sites where