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July 1979

Mixed Bullous Disease

Arch Dermatol. 1979;115(7):816. doi:10.1001/archderm.1979.04010070002003

To the Editor.—  Fifteen patients with herpes gestationis have been studied with immunofluorescence, and the findings reported,1,2 since Provost and Tomasi,3 have demonstrated C3 at the basement membrane zone in two cases in 1973. In all 17 cases, C3 was found at the basement membrane zone, while 11 showed IgG at the basement membrane zone by direct test, and only two showed circulating serum antibodies to the basement membrane zone (Table). These findings show herpes gestationis has distinct immunofluorescent characteristics, closer to bullous pemphigoid than it is to dermatitis herpetiformis, a concept that was previously based on clinical descriptions.Interesting atypical fluorescent findings have recently been reported in the bullous diseases.4-6 We now describe a unique case that was diagnosed as herpes gestationis on clinical grounds but with features of pemphigus and herpes gestationis on immunofluorescence testing.

Report of a Case.—  A maculopapular pruritic eruption developed on

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