Immunopathologic evaluation of the oral mucosa in dermatitis herpetiformis

Objective: The aim of the study was to evaluate the presence of IgA, IgG, IgM immunoglobulins and C3 component of the complement system in the oral mucosa of patients diagnosed with dermatitis herpetiformis.

Method: In 10 patients diagnosed with DH oral mucosa bioptates were investigated with the direct immunofluorescence method (DIF). Material collected from uninvolved buccal mucosa in local anesthesia was routinely processed with polyclonal rabbit antibodies against human IgG, IgA, IgM and C-3. The presence of deposits was demonstrated using the optic microscope (Zeiss) with fluorescent attachment and digital camera (Olympus). Statistical analysis was performed with bilateral Fisher test with significance level P <0.05. 

Result: Granular IgA deposits along the basal membrane of the oral epithelium were detected in 9 of 10 examined patients with DH. The deposits of C-3 component along the basal membrane of the oral epithelium were revealed in 5 of the examined subjects. In none of the patients the presence of IgG and IgM deposits in the oral mucosa bioptates was observed.

Conclusion:

1. The deposits of IgA and C-3 were revealed in the oral mucosa of the examined patients with dermatitis herpetiformis. 

2. The presence of IgA and C-3 deposits along the oral mucosa basal membrane may act as an important diagnostic indicator useful in the diagnosis of dermatitis herpetiformis.