Abstract
BACKGROUND: An important class of dermatological conditions known as immunobullous illnesses is brought on by pathogenic autoantibodies that target antigens in the dermo-epidermal junction or intercellular material. The accurate diagnosis plays a major role in the management of many disorders. Among bullous illnesses, different clinical signs have different diagnostic specificities. Clinical overlap exists across several categories of bullous disorders. Early vesicles should ideally undergo histological evaluation in order to identify the place of formation as well as the amount, kind, and makeup of the inflammatory infiltrate. The combination of these findings leads to the creation of a differential diagnosis. Blisters appear to indicate that blistering is too generic or vague to be used in a clinical gross examination, at least initially. These conditions do, however, continue to be linked to high rates of morbidity, high rates of death, and poor quality of life. An accurate diagnosis of vesiculobullous lesions in the skin requires a review of immunofluorescence, histopathologic, and clinical data.
AIM: The aim was to evaluate the correlation between clinical, histopathological, and direct immunofluorescence (DIF) patterns.
MATERIAL AND METHOD: Patients undergoing treatment at the hospital's Department of Pathology participated in a cross-sectional, descriptive study designed to investigate the clinical, histological, and DIF characteristics of vesiculobullous illnesses. Following approval from the institutional ethics committee and signed consent, vesiculobullous lesions were checked for in all patients visiting the dermatology outpatient department. A thorough history and clinical examination were performed on patients with vesiculobullous lesions, paying special attention to factors such as age, gender, the morphology of the lesions, the place of involvement, and clinical tests like the Bulla spread sign and Nikolsky's sign. Since these conditions have a variety of clinical presentations, patients with clinical characteristics suggestive of immunobullous, mechanobullous, severe adverse cutaneous medication reactions, or metabolic disorders were included in the study.
RESULTS: The Department of Pathology carried out a cross-sectional hospital descriptive research for the current investigation. Out of the 60 instances examined in this study, 53.3% (32 cases) had a mean age of 44.12 years (4–70 years), indicating a male majority; the remaining 46.6% (28 cases) had a mean age of 50.17 years (20–70 years). The bulk of patients (30%) were between the ages of 51 and 60, with a mean age of 47.04 years and a slight 1.07:1 male preponderance. In the study, the oldest patient was seventy years old, while the youngest was four years old.
CONCLUSION: In the current investigation, Pemphigus foliaceus and Pemphigus vulgaris could be distinguished only based on histological analysis. In order to distinguish between epidermolysis bullosa acquisita and bullous pemphigoid, which have a similar histological appearance, direct immunofluorescence was helpful. This work demonstrates that for vesiculobullous illnesses, direct immunofluorescence is both diagnostic and confirming. The final diagnosis of vesiculobullous illnesses is aided by the mixture or combination of clinical, histological, and DIF characteristics. None of these techniques is always diagnostic when used alone.
KEYWORDS: Vesiculobullous disorders, Bullous Pemphigoid and Direct immunofluorescence