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

Abstract

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 findingsResults: 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 dermatosesPunch 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.