Evaluation and correlation of clinical, histopathological and direct immunofluorescence findings in vesicobullous disorders of skin - A cross sectional study with review of literature

Authors

  • Geetika Sharma MBBS, MD Pathology, Senior resident, Department of Pathology, Lady Hardinge Medical College & Hospital, New Delhi – 110001
  • Shilpi Agarwal MBBS, MD Pathology, Professor, Department of Pathology, Lady Hardinge Medical College & Hospital, New Delhi - 110001
  • Ram Chander MBBS, MD Dermatology, Professor and Head, Department of Dermatology and STD, Lady Hardinge Medical College & Hospital, New Delhi - 110001

Keywords:

direct immunofluorescence, vesicobullous disorders, skin.

Abstract

Background: To assess and correlate the clinical, histopathological and DIF features and compare the sensitivity of DIF with that of histopathology in autoimmune bullous disorders of skin.

Methods: A cross-sectional descriptive hospital based study was conducted on 45 patients who had active vesicobullous lesions. After a detailed cutaneous examination, two punch biopsies were taken, one from lesional skin for histopathological study and another from perilesional skin for DIF. Biopsies from 31 patients were deemed fit to be included in the study.

Result: Based on clinical, histopathological and DIF findings the most common final diagnosis was Pemphigus Vulgaris (PV), 18/31 cases. On histopathology, characteristic histopathological features were seen in 15/18 cases of PV, 6/11 cases of Pemphigus Foliaceous (PF), 3/4 cases of Bullous Pemphigoid (BP) and a single case of Dermatitis Herpitiformis (DH) while 4/31 cases showed non  specific findings (NS). DIF was positive in 30/31 cases (96.77%) except in a single case of DH. Good clinico–histo-immunological correlation was seen in 21/31 cases (67.7%). In 25/31 cases (80.06%) good histo-immunological correlation (p < 0.05; significant) was observed while 6/31 cases (19.3%) showed discordance between histological and DIF findings. The senstivity of the histopathology in the pemphigus group (PV + PF + Paraneoplastic Pemphigus), BP and DH was 88%, 75% and 100% respectively while on DIF it was 100% for the pemphigus group and BP. Single case of DH was negative on DIF.

Conclusion: As compared to histopathology, DIF has better sensitivity and it is an indispensible tool especially in vesicobullous skin lesions that are difficult to diagnose on the basis of clinical and histopathological features.

References

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Published

10-08-2016

How to Cite

1.
Sharma G, Agarwal S, Chander R. Evaluation and correlation of clinical, histopathological and direct immunofluorescence findings in vesicobullous disorders of skin - A cross sectional study with review of literature. Ann of Pathol and Lab Med [Internet]. 2016 Aug. 10 [cited 2024 Nov. 19];3(3):A141-147. Available from: https://pacificejournals.com/journal/index.php/apalm/article/view/apalm671

Issue

Vol. 3 No. 3 (2016)

Section

Original Article

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Copyright (c) 2016 Geetika Sharma, Shilpi Agarwal, Ram Chander

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