Immunoelectron microscopic study of the conjunctiva in cicatricial pemphigoid

Background: Immune deposits can be found on the conjunctival basement membr ane zone of patients affected by cicatricial pemphigoid using immunofluores cence technique. The purpose of this study was to perform direct immunoelec tron microscopy on the conjunctiva of patients with scarring conjunctivitis associated with cicatricial-pemphigoid Methods: Conjunctival and skin biop sies were performed in six patients who presented with presumed autoimmune cicatrizing conjunctivitis associated with cicatricial pemphigoid. Specimen s were processed for direct immunofluorescence and direct immunoelectron mi croscopy. Results: Direct immunofluorescence was positive in all skin sampl es and in three of six conjunctival samples. Direct immunoelectron microsco py showed immune deposits in the lamina lucida and the lamina densa of all skin and conjunctival samples. Conclusions: Direct immunoelectron microscop y can be performed on the conjunctiva. It shows the precise localization of cicatricial pemphigoid target antigens within the conjunctival basement me mbrane zone.