Clinical, histopathological and immunofluorescent study of vesicobullous lesions of skin

Kumar, Seeram Satish; Atla, Bhagyalakshmi; Patnala, Guru Prasad; Srinivas, K; Samantra, Saraswathi; Priyanka, Akella Lakshmi Narasimha

doi:10.18203/2320-6012.ijrms20191341

Cited by 4 publications

(12 citation statements)

References 7 publications

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“…In our study Nikolsky sign was present in all the cases of Pemphigus vulgaris and negative in Bullous pemphigoid. This is in correlation with study by Deepthi et al and Kumar SS [4,6] . In the present study the plane of separation was subepidermal in majority of the cases (57.1%) followed by suprabasal (23.8%) and subcorneal planes (19.04%).…”

Section: Discussionsupporting

confidence: 92%

“…Similar findings were observed by Anupama [17] and Heena mittal. [19] Lesions were seen all over the body in studies by Deepti [4] Kumar SS [6] . Oral cavity involvement was seen in all the cases of pemphigus vulgaris and 2 cases showed only oral lesions without skin involvement.…”

Section: Discussionmentioning

confidence: 99%

“…Oral cavity involvement was seen in all the cases of pemphigus vulgaris and 2 cases showed only oral lesions without skin involvement. Many studies done show oral lesions associated predominantly with pemphigus vulgaris [1,2,4,6,17,18] . Bullous pemphigoid presented clinically as multiple, tense bullae of varying sizes commonly in adults, had the highest incidence in both males and females.…”

Section: Discussionmentioning

confidence: 99%

“…Our findings are similar to the findings from studiies by Thejasvi et al where Bullous pemphigoid was the predominant lesion [20] . Majority of the other studies showed pemphigus vulgaris as the predominant lesion [1,4,6,17,18] . This can be attributed to the genetic, environmental and geographical variations.…”

Section: Discussionmentioning

confidence: 99%

“…A blister is a fluid-filled cavity formed within or beneath the epidermis [5] . Vesiculobullous diseases have been the focus of intensive investigation in recent years as some of these can be extremely debilitating with serious sequelae, and even fatal, necessating early intervention and treatment to prevent further morbidity and mortality [4,6] . Clinical examination of skin bullous lesion provides the gross morphological findings upon which differential diagnosis can be made.…”

Section: Introductionmentioning

confidence: 99%

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Clinicopathological study of vesiculobullous lesions of the skin and the diagnostic utility of immunofluorescence

Pavani¹,

P²,

Deshpande³

2020

Int. J. Clin. Diagn. Pathol.

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Introduction: Vesicobullous disorders represent a heterogenous group of dermatoses with protean manifestations in which the primary lesion is a vesicle or a bulla on the skin or mucous membrane or both. These lesions can be extremely debilitating, may have serious sequelae, and even fatal, necessating early treatment and intervention to prevent further morbidity and mortality. Many of these blistering diseases mimic each other clinically, Histopathology together with immunofluorescence are used for diagnosing vesiculobullous lesions of skin. Materials and Methods: The present study is done at out institute for a period of 3 years from 2016 to 2019 All the vesiculo bullous lesions which we received during this period have been included in our study. We received a total of 42 cases during our study period. Light microscopic examination followed by DIF was done for definitive diagnosis. The pattern and distribution of immune complex deposits was analysed under fluorescence microscope and correlated with histological findings Results: Bullous pemphigoid was the common vesiculobullous disease (38.09%) followed by pemphigus vulgaris. dif showed linear type of immune deposits in epidermal basement membrane zone in bullous pemphigoid and in pemphigus vulgaris intercellular lace like deposition of immune complexes was seen. Conclusion:Vesiculobullous disorders represent a heterogeneous group of dermatoses Punch biopsy of the skin is a simple, inexpensive, safe OPD procedure, causing minimal discomfort lesions and DIF studies are an adjunct to the histomorphology. DIF which is the gold standard and sensitive test in making a definitive diagnosis aids in distinguishing non immune lesions from immune mediated lesions which pose a diagnostic dilemma both clinically and histologically An integrated approach of clinical findings in conjunct with histomorphology and DIF assist in accurate diagnosis and proper patient management.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinicopathological study of vesiculobullous lesions of the skin and the diagnostic utility of immunofluorescence

Pavani¹,

P²,

Deshpande³

2020

Int. J. Clin. Diagn. Pathol.

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Lymphocyte‐predominant lesional inflammatory infiltrates of the skin are associated with mucosal‐dominant phenotype in pemphigus

Papara

Dănescu

Liliana³

et al. 2023

J Cutan Pathol

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Introduction Pemphigus is a potentially life‐threatening autoimmune blistering disease. To date, studies assessing the association of histopathology with clinical phenotype are lacking. We sought to evaluate the main histopathologic findings and, also, the potential links between cutaneous inflammatory infiltrates and clinical characteristics in pemphigus. Methods We conducted a retrospective cohort study in patients diagnosed with pemphigus vulgaris (PV) and pemphigus foliaceus (PF) in a referral center for autoimmune blistering diseases. Results A total of 124 patients were included in the study (97 had PV and 27 had PF). On biopsy specimens, PV was more frequently associated with the “row of tombstones” feature (36.1% vs. 11.1%, p = 0.013), and PF was associated with acanthosis (44.4% vs. 23.7%, p = 0.034). Acantholysis was found in the upper half of the epidermis in PF (96.3% vs. 5.15%, p < 0.001), as opposed to the lower half in PV (75.2% vs. 0%, p = 0.002). Patients with lymphocyte‐predominant inflammatory infiltrates in lesional skin specimens presented with a higher frequency of the mucosal‐dominant phenotype (25.5% vs. 9.1%, p = 0.014), higher‐density cellular infiltrate (100% vs. 41.6%, p < 0.001), and more frequent acantholytic cells (42.6% vs. 23.4%, p = 0.025). Neutrophil‐predominant infiltrates in specimens from lesional skin were linked to a milder disease based on median Pemphigus Disease Area Index (38.9% vs. 13.2%, p = 0.036) and Autoimmune Bullous Skin Disorder Intensity Score (20.2 vs. 36.3, p = 0.019), while eosinophil‐predominant inflammatory infiltrates were more often associated with eosinophilic spongiosis (100% vs. 23.1%, p = 0.014). Conclusions Lymphocyte‐predominant infiltrates in lesional skin specimens of pemphigus patients predict a mucosal‐dominant phenotype, while neutrophil‐predominant infiltrates are associated with a milder disease.

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Histomorphological study of vesiculobullous lesions of skin: a study of 66 cases at tertiary care center

et al. 2023

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Background: Wide variety of pathological processes can lead to development of vesiculobullous eruptions over the body. They may occur in many dermatoses which include various inflammatory, infective, autoimmune, drug induced as well as genetic conditions. Each entity of vesiculobullous lesion has similar or confusing clinical features but different histopathological morphology outcome. However, these disorders are still associated with substantial morbidity, considerable mortality and impaired quality of life. Histopathological examination is helpful in definitive diagnosis of vesiculobullous disorder which is very essential for specific treatment and an appropriate desirable outcome. Aim was to study and classify various vesiculobullous lesions of the skin. Methods: It was a hospital based prospective and retrospective study conducted for a period from January 2016 to July 2019 in the department of pathology at Government medical college, Surat, Gujarat. Total of 66 patients, aged 3-70 years with vesiculobullous lesions of both sexes attending the department of dermatology were selected and analysed clinically. The specimens were routinely processed and hematoxylin and eosin stained slides were studied. Results: In the present study, majority of patients presented between 41-50 years of age (32%) with male to female ratio of 1.08:1. Pemphigus vulgaris constituted the most common vesiculobullous disorder (30.30%) followed by pemphigus foliaceous (24.24%) followed by bullous pemphigoid (15.05%). Bullae were located intra epidermally in (36%+24.78%) and sub epidermally in 24% of the patients. Conclusions: Thorough histopathological workup and clinical correlation is essential to confirm diagnosis of vesiculobullous lesions of skin.

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Clinical, histopathological and immunofluorescent study of vesicobullous lesions of skin

Cited by 4 publications

References 7 publications

Clinicopathological study of vesiculobullous lesions of the skin and the diagnostic utility of immunofluorescence

Clinicopathological study of vesiculobullous lesions of the skin and the diagnostic utility of immunofluorescence

Lymphocyte‐predominant lesional inflammatory infiltrates of the skin are associated with mucosal‐dominant phenotype in pemphigus

Histomorphological study of vesiculobullous lesions of skin: a study of 66 cases at tertiary care center

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