What abnormalities in structural components of the basement membrane are involved in bullous skin diseases?

Structures within the basement membrane can be congenitally absent or decreased in number, or, as with the epidermal desmosomes, they can be affected by antibodies directed against them. In the uppermost portion of the BMZ, in the lamina lucida, hemidesmosomes bind the basal keratinocytes to the basement membrane.

Bullous pemphigoid is an acquired blistering disease in which antihemidesmosomal antibodies are produced. These antibodies appear to induce inflammation and subsequent damage to the hemidesmosomes, causing a blister to develop between the cells and basement membrane.