The Spectrum of Histopathologic Findings in Pemphigoid: Avoiding Diagnostic Pitfalls.

MedStar author(s):
Citation: Journal of Cutaneous Pathology. 45(11):831-838, 2018 Nov.PMID: 30141231Institution: MedStar Washington Hospital Center Department: DermatologyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Pemphigoid, Bullous/di [Diagnosis] | *Pemphigoid, Bullous/pa [Pathology] | HumansYear: 2018ISSN:
  • 0303-6987
Name of journal: Journal of cutaneous pathologyAbstract: BACKGROUND: Bullous Pemphigoid (BP) is an autoimmune vesiculobullous dermatitis that primarily affects the elderly and presents with tense, fluid-filled blisters. The histological hallmark on routine hematoxylin & eosin stained specimens is a subepidermal blister with luminal eosinophils. However, there are histologic variants than can produce diagnostic confusion.CONCLUSION: While re-epithelialization of subepidermal blisters is a commonly accepted phenomenon, there is no published data demonstrating its incidence. Because only half of the biopsies showed the classic subepidermal blister, it is important to be aware of the spectrum of histopathologic findings that occur in this disease. Specifically, the presence of an intraepidermal blister and/or epidermal necrosis on routine hematoxylin & eosin stained specimens does not preclude the diagnosis of pemphigoid. This article is protected by copyright. All rights reserved.METHODS: All immunofluorescence reports from an independent certified dermatopathology laboratory (2006-2015) were inspected, and those with findings consistent with an autoimmune subepidermal blistering process were selected. Seventy-seven cases were identified, and the corresponding hematoxylin & eosin stained specimens were reviewed by two dermatopathologists who tabulated the histopathologic findings.RESULTS: Just over half of biopsies showed subepidermal clefting (54%). The histologic variants included: urticarial or eczematous findings (17%); partial or complete re-epithelialization (28%); and epidermal necrosis (7%).This article is protected by copyright. All rights reserved.All authors: Brodell RT, Googe A, Hodge B, Patel T, Reserva JL, Roach J, Schulmeier JFiscal year: FY2019Digital Object Identifier: ORCID: Date added to catalog: 2018-08-31
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 30141231 Available 30141231

BACKGROUND: Bullous Pemphigoid (BP) is an autoimmune vesiculobullous dermatitis that primarily affects the elderly and presents with tense, fluid-filled blisters. The histological hallmark on routine hematoxylin & eosin stained specimens is a subepidermal blister with luminal eosinophils. However, there are histologic variants than can produce diagnostic confusion.

CONCLUSION: While re-epithelialization of subepidermal blisters is a commonly accepted phenomenon, there is no published data demonstrating its incidence. Because only half of the biopsies showed the classic subepidermal blister, it is important to be aware of the spectrum of histopathologic findings that occur in this disease. Specifically, the presence of an intraepidermal blister and/or epidermal necrosis on routine hematoxylin & eosin stained specimens does not preclude the diagnosis of pemphigoid. This article is protected by copyright. All rights reserved.

METHODS: All immunofluorescence reports from an independent certified dermatopathology laboratory (2006-2015) were inspected, and those with findings consistent with an autoimmune subepidermal blistering process were selected. Seventy-seven cases were identified, and the corresponding hematoxylin & eosin stained specimens were reviewed by two dermatopathologists who tabulated the histopathologic findings.

RESULTS: Just over half of biopsies showed subepidermal clefting (54%). The histologic variants included: urticarial or eczematous findings (17%); partial or complete re-epithelialization (28%); and epidermal necrosis (7%).

This article is protected by copyright. All rights reserved.

English

Powered by Koha