Pemphigoid: Bullous, gestational, and cicatricial

The term pemphigoid applies to cutaneous diseases that are characterized clinically (1) by the presence of large tense blisters that lack a Nikolsky sign, (2) by subepidermal blister formation with an inflammatory infiltrate usually rich in eosinophils, and (3) by the deposition of IgG and complement components in affected skin or mucous membrane. Adding to the traditional definition of “pemphigoid” is the definition that considers where the immunoreactants are deposited at the ultrastructural level and the definition of the antigens recognized by the autoantibodies. For example, current data indicate that bullous pemphigoid and herpes gestationis are closely related by all the above criteria. The antigens that are recognized by autoantibodies in both syndromes are discussed. Cicatricial pemphigoid is less well understood, and its relationship to these diseases is unclear at present. These diseases provide a significant challenge for future research and potentially will offer insights into immune dysfunction in select patient populations.