Herpes gestationis. Ultrastructure and ultrastructural localization of in vivo-bound complement.

Ultrastructural localization of C3 deposition in the skin of two patients with herpes gestationis was determined by using a peroxidase-antiperoxidase multistep technique. The tissue preparations can be stored for long periods of time and identical sections may be used for light and electron microscopic examination. The reaction products were seen throughout the entire lamina lucida and the basal cell plasma membrane appeared to be accentuated. The most remarkable ultrastructural changes in normal-appearing skin were the destruction of the basal cell membranes on the dermal side, localized cytoplasmic dissolution, and intracellular edema unaccompanied by inflammatory cells. Early, nonvesicular lesions showed basal cell degeneration and dermal inflammatory cells. Necrosis and loss of basal cells occurred in the next stage which resulted in microvesicles in which collagen or a well-preserved basal lamina formed the vesicle base. In the later blister stage, the basal lamina was usually lost. It is suggested that damage of basal cell membranes on their dermal side leads to the destruction of basal cells with the subsequent protrusion of epidermal and junctional substances into the dermis. This may result in inflammatory cell infiltration and blister formation.