Publication: Microscopía confocal en las enfermedades ampollosas subepidérmicas autoinmunes
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2017-02-07
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Universidad Complutense de Madrid
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Abstract
Las enfermedades ampollosas subepidérmicas autoinmunes constituyen un complejo grupo de trastornos cutáneos en cuya patogenia se rompe la unión dermoepidérmica. Su alta morbilidad se debe a la afectación de grandes áreas cutáneas por ampollas, erosiones o cicatrices y a la posible afectación de las mucosas oral, conjuntival, laríngea, esofágica y genitourinaria. Además, se ha demostrado su asociación con enfermedades neurológicas degenerativas y neoplasias. Existe un gran solapamiento clínico e histológico entre múltiples enfermedades, ya que varios antígenos de la membrana basal pueden estar implicados. En las dos últimas décadas se han producido grandes avances para intentar descubrir todos los antígenos implicados y la posible correlación clínico-inmunológica entre manifestaciones clínicas y antígenos diana. La inmunofluorescencia directa e indirecta y técnicas serológicas como el ELISA se realizan ya de rutina en centros de referencia. Sin embargo, estas técnicas no siempre llegan al diagnóstico de certeza. El desarrollo de nuevas técnicas inmunológicas más sensibles, específicas y reproducibles contribuirá a que los diagnósticos sean más exactos y por tanto el manejo terapéutico y pronóstico de los enfermos sea mejor. La microscopía confocal es una técnica prometedora en este campo...
Subepidermal autoimmune bullous diseases are a complex group of entities featuring rupture of the dermal-epidermal junction. Its high morbidity is caused by blisters, erosions and scars all over the skin surface. Involvement of mucous membranes (oral, conjunctival, laryngeal, esophagic and genital) is possible. Besides, an association with neurologic and oncologic disease has been stated. There is a great clinical and histological overlap between different diseases, because several antigens can be involved. In the last two decades, new antigens have been discovered, with clinicalimmunological correlation. Direct immunofluorescence, indirect immunofluorescence and serological techniques such as ELISA are already performed in referral centers. However, these techniques do not always lead to a certain diagnosis. Development of new immunological tests, sensitive, specific and reproducible will improve diagnostic accuracy, patient management and prognosis. Confocal microscopy is a promising technique in this field...
Subepidermal autoimmune bullous diseases are a complex group of entities featuring rupture of the dermal-epidermal junction. Its high morbidity is caused by blisters, erosions and scars all over the skin surface. Involvement of mucous membranes (oral, conjunctival, laryngeal, esophagic and genital) is possible. Besides, an association with neurologic and oncologic disease has been stated. There is a great clinical and histological overlap between different diseases, because several antigens can be involved. In the last two decades, new antigens have been discovered, with clinicalimmunological correlation. Direct immunofluorescence, indirect immunofluorescence and serological techniques such as ELISA are already performed in referral centers. However, these techniques do not always lead to a certain diagnosis. Development of new immunological tests, sensitive, specific and reproducible will improve diagnostic accuracy, patient management and prognosis. Confocal microscopy is a promising technique in this field...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina, leída el 15-01-2016