Immunohistological skin investigations in patients with the acquired immune deficiency syndrome.

Twenty-one male patients with acquired immune deficiency syndrome (AIDS), 6 male patients with AIDS-related complex (ARC) and 23 controls' had a punch biopsy taken from clinically unaffected skin of the buttock. Vertical skin sections were examined by immunofluorescence for in vivo deposits of immunoglobulins (Ig) and other plasma proteins, as well as for morphology and distribution of Langerhans cells (LC). Deposits of IgM in the dermo-epidermal junction zone (DEJ) were found in one patient with ARC. Apart from this single finding, no in vivo deposits of IgG, IgM, IgA, IgD, IgE, complement C1q and C3, fibrinogen or albumin were demonstrated in epidermis, DEJ or dermal vessel walls, either in patients or in controls. Epidermal LC were more superficially situated in patients as compared to controls. No differences in number and localisation of dermal LC were seen. We concluded that it was not possible to confirm a recent report of in vivo Ig deposits in the epidermis of patients with AIDS. The abnormalities observed in epidermal LC should be interpreted together with the recent finding of reduced numbers of epidermal LC; they thus support the hypothesis that LC are involved in the pathological processes in AIDS.