Original Research Article
Year: 2021 | Month: March | Volume: 8 | Issue: 3 | Pages: 742-750
Clinico-Pathological Study of Immunobullous Disorders with Special Reference to Immunofluorescence
Arkadip Paul1, Keya Basu1, Ranjana Bandhopadhyay1, Abhishek De2, Priyanka Dutta3
1MD Resident, Department of Pathology, Calcutta National Medical College.
1Ex-Professor & HOD, Department of Pathology, Calcutta National Medical College
1Ex-Associate Professor, Department of Pathology, Calcutta National Medical College
2Associate Professor, Department of Dermatology, Calcutta National Medical College
3Senior Research Fellow, Department of Oncogene Regulation Unit, Chittaranjan National Cancer Institute.
Corresponding Author: Arkadip Paul
ABSTRACT
Background: Autoimmune bullous diseases are group of blistering dermatosis in which pathogenic autoantibodies are directed against various target antigens against adhesion complex molecules in epidermis and dermo- epidermal junction which leads to gradual weakening of intercellular bridges between adjacent keratinocytes and those of with basement membrane and subsequent blister formation. The yearly worldwide incidence of this disease category is about 0.3/100000
Aims:
1.To study the clinical and pathological characteristics of autoimmune bullous diseases.
2. To study direct immunofluorescence characteristics of different subgroups of autoimmune bullous diseases
3. To find out the clinico-pathological correlation of different subgroups of autoimmune bullous diseases.
Materials and Methods: Cross sectional study was done on 35 patients under dermatology department, detailed clinical history, examinations and routine investigations were recorded according to the case record form. Tzanck smear was prepared from blister fluid and stained by Leishman Giemsa stain for cytological examination to screen out presence of acantholytic cells. Histopathology and immunofluorescence study of two biopsies from lesional and perilesional skin were done under the department of pathology.
Results: Clinical, histopathological and direct immunofluorescence concordance varies considerably among the spectrum of diseases. The concordance was 81% in pemphigus vulgaris, 60% in pemphigus foliaceus, 50% in bullous pemphigoid and, 50% in dermatitis herpetiformis. We had two cases of linear IgA bullous disease and only one case of Pemphigoid gestationis. The percentages of concordance in these cases were 100%, for both. Out of 35 cases of autoimmune vesiculobullous diseases clinical, histopathological and immunological correlation was present in 26 cases (74.2%).
Keywords: Immunobullous, Tzanck smear, Direct immunofluorescence.
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