Local involvement of antigen-presenting cells and activated T cells in perilesional and clinically uninvolved skin in pemphigus vulgaris.

Biopsies obtained from both the perilesional areas and clinically uninvolved skin of patients with pemphigus vulgaris (PV) were studied for antigen-presenting cell and lymphocyte phenotype and/or activation phenotype using monoclonal antibodies in avidin-biotin-peroxidase complex staining. Perilesional PV skin contained CD4+ and CD8+ T lymphocytes as the predominant cell type, but cells with a potential antigen-presenting function displaying CD11b phenotype of monocyte/macrophages and, in particular, CD1 phenotype of Langerhans cells were also present. The number of mononuclear inflammatory cells was greater in perilesional than in clinically uninvolved PV skin, and so were the proportions of CD4+, CD8+, CD25+, Ia+ cells (p less than 0.01), and CD1+ Langerhans cells and transferrin receptor positive cells (p less than 0.05). These findings confirm and extend earlier observations on local involvement of immunocompetent cells in PV.