Clinical and pathological study of autoimmune vesiculobullous disorders

Chandramohan Kudligi, Arun Thirunavukkarasu, Vidya Kuntoji, Pradeep Vittal Bhagwat, Ravi Rathod, Sujata Girian, Amita Sharma, Veena Andanappanavar

Abstract


Objective To study the various clinical presentations - age of onset, sex preponderance, course of disease and histopathological patterns of autoimmune vesiculobullous disorders and correlate clinical and histopathological findings and immunofluorescence with clinical and histopathological findings in few affordable cases.

 

Methods The present descriptive study was undertaken in a tertiary care hospital over a period of 2 years. It included 50 patients of autoimmune vesicobullous diseases fulfilling inclusion criteria. Diagnosis was established by clinical and histopathological findings. Direct immunofluorescence (DIF) testing was done in few affordable patients.

 

Results Autoimmune vesiculobullous disorders constituted 0.128% of skin disease. Pemphigus vulgaris (62%) constituted the most common vesiculobullous disorder. Females (58%) outnumbered males (42%). The age group ranged from 11 years to 85 years and the mean age was 46.2 (15.6) years. The duration of the diseases ranged from less than a week to more than a year. Tzanck smear findings revealed acantholytic cells in 90.3% cases of pemphigus vulgaris and all cases of pemphigus foliaceus and pemphigus erythematosus. Correlation between clinical and histopathological findings was seen in 96% of cases and that between histopathological and DIF findings in 89% of cases.

 

Conclusion After the preliminary clinical and cytological diagnosis, histopathology and DIF are required to confirm the diagnosis. Considering the socioeconomic situations of the patients and unavailability of immunofluorescence technique widely, the study showed that clinical features and histopathology are fairly specific and cost-effective in arriving at the diagnosis.

 


Keywords


Autoimmune vesicobullous disorders, pemphigus vulgaris, direct immunofluorescence, correlation

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References


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