Stellenwert der histologischen untersuchung in der diagnostik bullöser autoimmundermatosen

The histopathological picture of many autoimmune bullous dermatoses is considered to be relatively characteristic. However, different entities may show similar histological findings. In addition, the picture depends on both the stage of the disease and prior treatment. Autoimmune bullous dermatoses are characterized by the production of autoantibodies to structural proteins of the skin. In most instances, the autoantigens have been identified and are available as recombinant proteins. Utilizing these recombinant forms, specific and sensitive assays have been developed for the detection of circulating autoantibodies in the serum. The detection of autoantibodies in skin or mucous membranes and/or serum is required for the diagnosis of autoimmune bullous dermatoses. The task of the dermatopathologist in the diagnostic process of autoimmune bullous dermatoses is to describe precisely the histopathological findings, to mention differential diagnoses and to recommend how these can be confirmed or excluded by immunopathological and immunoserological studies.