Johns Hopkins Dermatology
I will attempt to clarify what we know about the antibody response in various forms of pemphigus and how the distribution of the targeted antigens affects the location of lesions. The synthesis of this work has been proposed by Dr. John Stanley, with key published advances from Dr. Masa Amagai and Mai Mahoney, Ph.D., P. Koch and others. John Stanley refers to his concept as the “desmoglein compensation hypothesis”. The key to this hypothesis is the desmogleins (pemphigus antigens) are key adhesion molecules that keep cells attached to each other. In some areas of the body, there are two desmogleins present, and both have to be damaged to cause cell detachment – in some areas only one desmoglein may be present at some level in the skin or mucous membrane, and there only one desmoglein has to be damaged to cause cell detachment.