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A Clinicopathological and Immunofluorescence Study of Intraepidermal Immunobullous Diseases

CONTEXT: Autoimmune blistering diseases (AIBDs) are characterized by autoantibodies directed against antigens of skin. Direct immunofluorescence (DIF) study helps in confirming the diagnosis where histopathology alone is noncontributory. AIMS: This study aimed to evaluate the clinicopathological and...

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Detalles Bibliográficos
Autores principales: Basu, Keya, Chatterjee, Moumita, De, Abhishek, Sengupta, Moumita, Datta, Chhanda, Mitra, Pradip
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440185/
https://www.ncbi.nlm.nih.gov/pubmed/30983604
http://dx.doi.org/10.4103/ijd.IJD_515_17
Descripción
Sumario:CONTEXT: Autoimmune blistering diseases (AIBDs) are characterized by autoantibodies directed against antigens of skin. Direct immunofluorescence (DIF) study helps in confirming the diagnosis where histopathology alone is noncontributory. AIMS: This study aimed to evaluate the clinicopathological and DIF features of intraepidermal AIBD and to assess their relative diagnostic significance. MATERIALS AND METHODS: It was an institution-based observational study. A total of 34 patients were studied over a period of 1½ years in the Department of Pathology in collaboration with the Department of Dermatology of a tertiary care hospital. The clinical, pathological, and DIF features were evaluated and documented. STATISTICAL ANALYSIS: Data were analyzed by statistical tests using GraphPad InStat. RESULTS: Pemphigus vulgaris (PV) was the predominant type with 18 (53%) cases followed by 15 (44%) cases of pemphigus foliaceus (PF) and a single case of pemphigus erythematosus (PE). The age of the patients ranged from 17 to 85 years. Overall, there was a female preponderance in the study group. The most common presenting feature was pruritus (58.82%). Tzanck smear showed the presence of acantholytic cells in thirty (88.24%) patients. Characteristic histopathological features were present in all the cases of PV and PF except one case of PF which was found to be a case of PE. DIF study showed intraepidermal deposition of intercellular immunoglobulin G (IgG) and C3 both in PV and PF. The case of PE showed epidermal “antinuclear antibody” staining with IgG. CONCLUSION: Immunofluorescence study may be used as an additional tool for confirmation of diagnosis where histopathology alone is inconclusive.