BACKGROUND: Elevated levels of antibody to streptococcal exoenzymes have been found in @entity1 with @entity1569 or @entity5144 . Research on the role of streptococcal antigen in @entity1569 has been hampered by a potential molecular mimicry between streptococcal epitopes and @entity1 epidermal keratin. OBJECTIVE AND METHODS: Evidence of microbial product was sought in skin biopsies of @entity1569 @entity1 thought clinically to have either streptococcal carrier state or gastrointestinal candidal colonization. A polyclonal antibody to streptococcal-derived exoenzymes unlikely to share antigenic structures with normal @entity1 skin, and an anticandidal antibody, were used with linked streptavidin @entity1885 amplification stain. RESULTS: The predicted microbial product appeared heavily in lesional epidermis, but unexpectedly also as a thin deposit along the skin basement membrane zone (SBMZ) of apparently unaffected skin. Staining was negative for nonpsoriatic subjects. CONCLUSIONS: The findings support a direct effect of microbial antigen in @entity1569 . They also suggest an important role for SBMZ as a very large adhesive surface in the first step of a process of percutaneous epidermal elimination of foreign antigens and microbial toxins. The many autoimmune phenomena seen so often at the SBMZ are probably a physiologic part of this important immune function. Efforts to enhance the adhesive properties of SBMZ should be exploitable for both diagnostic and therapeutic benefit.

Skin basement membrane zone: a depository for circulating microbial antigen evoking XXXX and autoimmunity.

@entity1 :: ('9606', 'Species') :: ['human', 'patients'] @entity1569 :: ('MESH:D011565', 'Disease') :: ['psoriasis'] @entity5144 :: ('MESH:D015535', 'Disease') :: ['psoriatic arthritis'] @entity1885 :: ('MESH:D001710', 'Chemical') :: ['biotin']
@entity1569 :: (MESH:D011565,Disease) :: ['psoriasis']
