A clinicopathological and immunofluorescence study of immunobullous disorders

• Author Details:   
• Sowmyashree Krishna ^*
• Anusree V Sreedharan
• Kikkeri N Naveen
• Aditya Agnihotri
• Sweta R Prabhu

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Aim and Objective: The aim of the study was to evaluate the clinicodemographic profile, histopathology and DIF findings of patients with immunobullous disorders to facilitate diagnostic accuracy and optimal treatment.
Background: Immunobullous disorders are blistering disorders in which autoantibodies are directed against target antigens present in the epidermis and dermo-epidermal junction. With a myriad of presentations, they still remain an enigma. Histopathology and direct immunofluorescence (DIF) play a major role in diagnosing such conditions.
Materials and Methods: A retrospective study was conducted in a tertiary hospital in North Karnataka over a period of 24 months. Data was collected from the hospital medical records department. All clinically diagnosed cases of immunobullous disorders who were subjected to histopathology and direct immunofluorescence were included in the study.
Results: In the present study, among the total 63 cases of immunobullous disorders, the predominant type was pemphigus vulgaris (63.49%), followed by bullous pemphigoid (26.98%), pemphigus foliaceous (6.34%), and one case each of pemphigus vegetans and chronic bullous disorder of childhood. In 85.71% of the cases, histopathology showed suprabasal, subcorneal or sub-epidermal blister. Histopathology findings were consistent with clinical diagnosis in 73.01% cases. Cases with inconclusive biopsy findings were diagnosed using DIF. DIF was diagnostic in majority (90.47%) of patients.
Conclusion: Histopathology with clinical correlation plays a major role in differentiating various subtypes of immunobullous disorders and DIF can be used as a confirmatory tool in inconclusive cases.

Keywords: Immunobullous disorders, Histopathology, Direct immunofluorescence