HISTOPATHOLOGICAL STUDY OF VESICULOBULLOUS LESIONS OF SKIN WITH SPECIAL REFERENCE TO DIRECT IMMUNOFLUORESCENCE

Abstract

Skin represents a window to the internal well-being of the disease. Vesiculobullous diseases represents a heterogenous group of dermatoses with protean manifestations. One of the main reason for continued identication of new bullous diseases is because the diagnosis is based on immunological & molecular basis in addition to clinical ndings & immunomorphology. This study aims to correlate Direct Immunouorescence with clinical and Histopathological ndings and to analyze the utility of Immunouorescence in the diagnosis of vesiculobullous lesions of skin. A total of 50 cases were evaluated with vesiculobullous lesions with clinical history, signs, histopathological and immunouorescence studies. In this study, Bullous Pemphigoid and Pemphigus vulgaris constituted 82 % of cases. Oral mucosal involvement was present in 89.5 % cases of Pemphigus Vulgaris & 22.7% cases of Bullous pemphigoid. Subepidermal blister/ bullae is commonest in the study, next being supra basal blister/ bullae. 71.4 % were positive for Direct IF in which 2/3 cases staining pattern was throughout the entire epidermis & in 1/3 cases staining pattern was restricted to lower 1/3 of epidermis. 50% of Dermatitis Herpetiformis showed positive staining by IgA in papillary dermis showing granular BM zone pattern. In Bullous Pemphigoid subjected for DIF, 70% cases were positive with linear basement membrane zone deposition of antibodies.