DELAYED POSTBURN BLISTERS - AN IMMUNE HISTOCHEMICAL AND ULTRASTRUCTURAL-STUDY

This study was performed in an attempt to further elucidate the pathog enesis of delayed postburn blistering. Two cases were studied ultrastr ucturally and immunohistochemically, 1 with blisters on the recipient site of autologous split-thickness skin grafts and the other on the do nor site. Ultrastructurally, the basement membrane was on the roof of the blisters in both cases, except for a single small blister in the f irst case where it was on the dermal floor. In the blister roofs, the basement membrane showed small or marked segments of discontinuity. In the adjacent non-blistered healed skin, the basement membrane was usu ally continuous, and anchoring fibrils were present. Immunoperoxidase staining on frozen sections, using antibodies to laminin, laminin 5, c ollagen IV, and collagen VII, showed a mostly continuous linear patter n in the adjacent non-blistered skin, which often became discontinuous near the blisters and markedly discontinuous in the blister roofs. In the blister floors, weakly stained linear or granular deposits of som e of these components were sometimes also present. The results of this study support discontinuity of the basement membrane as the main anom aly in delayed postburn blistering. Disturbance in the reassembly or l ocal breakdown of the basement membrane components might be the underl ying defect. (C) Munksgaard 1997.