Morphological Spectrum of Vesiculobullous Skin Lesions: An Institutional Perspective

Introduction A vesiculobullous lesion of the skin encompasses a group of dermatological disorders with protean clinicopathological features. They usually occur as a part of the spectrum of various infectious, inflammatory, drug-induced, genetic, and autoimmune disorders. Therefore, accurate diagnosi...

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Veröffentlicht in:Curēus (Palo Alto, CA) CA), 2021-05, Vol.13 (5), p.e15330-e15330
Hauptverfasser: Ali, Javaria, Islam, Sabeeh, Ali, Syed Munqaad, Yaqeen, Syed Rafay, Aslam, Anum, Khan, Qurat ul ain, Malik, Umair Arshad, Irfan, Muhammad, Naqvi, Hanna, Hashmi, Atif A
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container_title Curēus (Palo Alto, CA)
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creator Ali, Javaria
Islam, Sabeeh
Ali, Syed Munqaad
Yaqeen, Syed Rafay
Aslam, Anum
Khan, Qurat ul ain
Malik, Umair Arshad
Irfan, Muhammad
Naqvi, Hanna
Hashmi, Atif A
description Introduction A vesiculobullous lesion of the skin encompasses a group of dermatological disorders with protean clinicopathological features. They usually occur as a part of the spectrum of various infectious, inflammatory, drug-induced, genetic, and autoimmune disorders. Therefore, accurate diagnosis of these lesions is essential for appropriate management and to reduce the associated morbidity and mortality. The conventional skin punch biopsy is the mainstay in the diagnosis of dermatological diseases, especially when combined with confirmatory tests, such as direct immunofluorescence (DIF). Our study evaluated the clinicopathological spectrum of vesiculobullous lesions. Methods We studied 150 cases of vesiculobullous lesions at the Department of Histopathology, Liaquat National Hospital and Medical College Karachi, Pakistan. Written and informed consent was taken from the patients followed by skin punch procedure in which three biopsies were obtained, which included one biopsy from the lesion and two peri-lesional biopsies. One peri-lesional biopsy was sent in cryomatrix for DIF studies, whereas the other two were sent in formalin to follow the standard tissue-processing protocol. Results Our results showed that most patients belonged to the geriatric age group of more than 50 years (44.7%), and 54.7% of the patients were females. Total 74.7% of the patients had generalized lesions, followed by lower limbs (9.3%) and trunk (7.3%) involvement. Most patients were diagnosed with bullous pemphigoid (31.3%), followed by pemphigus vulgaris (27.3%), dermatitis herpetiformis (15.3%), Darier’s disease (14.7%), pemphigus foliaceus (4.7%), epidermolysis bullosa (2%), linear immunoglobulin A dermatosis (2%), paraneoplastic pemphigus (0.7%), and drug reactions (0.7%). DIF studies were applied on 60 cases, out of which complement protein C3c was the most commonly deposited protein (53.3%). Conclusion Our study emphasized the diagnostic role of skin punch biopsy in the proper evaluation of vesiculobullous skin lesions. Histopathology is the cornerstone diagnostic tool in this regard, with DIF being a useful adjunct.
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They usually occur as a part of the spectrum of various infectious, inflammatory, drug-induced, genetic, and autoimmune disorders. Therefore, accurate diagnosis of these lesions is essential for appropriate management and to reduce the associated morbidity and mortality. The conventional skin punch biopsy is the mainstay in the diagnosis of dermatological diseases, especially when combined with confirmatory tests, such as direct immunofluorescence (DIF). Our study evaluated the clinicopathological spectrum of vesiculobullous lesions. Methods We studied 150 cases of vesiculobullous lesions at the Department of Histopathology, Liaquat National Hospital and Medical College Karachi, Pakistan. Written and informed consent was taken from the patients followed by skin punch procedure in which three biopsies were obtained, which included one biopsy from the lesion and two peri-lesional biopsies. One peri-lesional biopsy was sent in cryomatrix for DIF studies, whereas the other two were sent in formalin to follow the standard tissue-processing protocol. Results Our results showed that most patients belonged to the geriatric age group of more than 50 years (44.7%), and 54.7% of the patients were females. Total 74.7% of the patients had generalized lesions, followed by lower limbs (9.3%) and trunk (7.3%) involvement. Most patients were diagnosed with bullous pemphigoid (31.3%), followed by pemphigus vulgaris (27.3%), dermatitis herpetiformis (15.3%), Darier’s disease (14.7%), pemphigus foliaceus (4.7%), epidermolysis bullosa (2%), linear immunoglobulin A dermatosis (2%), paraneoplastic pemphigus (0.7%), and drug reactions (0.7%). DIF studies were applied on 60 cases, out of which complement protein C3c was the most commonly deposited protein (53.3%). Conclusion Our study emphasized the diagnostic role of skin punch biopsy in the proper evaluation of vesiculobullous skin lesions. Histopathology is the cornerstone diagnostic tool in this regard, with DIF being a useful adjunct.</description><identifier>ISSN: 2168-8184</identifier><identifier>EISSN: 2168-8184</identifier><identifier>DOI: 10.7759/cureus.15330</identifier><identifier>PMID: 34235011</identifier><language>eng</language><publisher>Palo Alto (CA): Cureus</publisher><subject>Dermatology ; Pathology</subject><ispartof>Curēus (Palo Alto, CA), 2021-05, Vol.13 (5), p.e15330-e15330</ispartof><rights>Copyright © 2021, Ali et al. 2021 Ali et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c248t-e488e65226fc5e83bb10305448efb862c7dfed478e0996f90b0c789e3a9048e43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8240674/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8240674/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids></links><search><creatorcontrib>Ali, Javaria</creatorcontrib><creatorcontrib>Islam, Sabeeh</creatorcontrib><creatorcontrib>Ali, Syed Munqaad</creatorcontrib><creatorcontrib>Yaqeen, Syed Rafay</creatorcontrib><creatorcontrib>Aslam, Anum</creatorcontrib><creatorcontrib>Khan, Qurat ul ain</creatorcontrib><creatorcontrib>Malik, Umair Arshad</creatorcontrib><creatorcontrib>Irfan, Muhammad</creatorcontrib><creatorcontrib>Naqvi, Hanna</creatorcontrib><creatorcontrib>Hashmi, Atif A</creatorcontrib><title>Morphological Spectrum of Vesiculobullous Skin Lesions: An Institutional Perspective</title><title>Curēus (Palo Alto, CA)</title><description>Introduction A vesiculobullous lesion of the skin encompasses a group of dermatological disorders with protean clinicopathological features. They usually occur as a part of the spectrum of various infectious, inflammatory, drug-induced, genetic, and autoimmune disorders. Therefore, accurate diagnosis of these lesions is essential for appropriate management and to reduce the associated morbidity and mortality. The conventional skin punch biopsy is the mainstay in the diagnosis of dermatological diseases, especially when combined with confirmatory tests, such as direct immunofluorescence (DIF). Our study evaluated the clinicopathological spectrum of vesiculobullous lesions. Methods We studied 150 cases of vesiculobullous lesions at the Department of Histopathology, Liaquat National Hospital and Medical College Karachi, Pakistan. Written and informed consent was taken from the patients followed by skin punch procedure in which three biopsies were obtained, which included one biopsy from the lesion and two peri-lesional biopsies. One peri-lesional biopsy was sent in cryomatrix for DIF studies, whereas the other two were sent in formalin to follow the standard tissue-processing protocol. Results Our results showed that most patients belonged to the geriatric age group of more than 50 years (44.7%), and 54.7% of the patients were females. Total 74.7% of the patients had generalized lesions, followed by lower limbs (9.3%) and trunk (7.3%) involvement. Most patients were diagnosed with bullous pemphigoid (31.3%), followed by pemphigus vulgaris (27.3%), dermatitis herpetiformis (15.3%), Darier’s disease (14.7%), pemphigus foliaceus (4.7%), epidermolysis bullosa (2%), linear immunoglobulin A dermatosis (2%), paraneoplastic pemphigus (0.7%), and drug reactions (0.7%). DIF studies were applied on 60 cases, out of which complement protein C3c was the most commonly deposited protein (53.3%). Conclusion Our study emphasized the diagnostic role of skin punch biopsy in the proper evaluation of vesiculobullous skin lesions. Histopathology is the cornerstone diagnostic tool in this regard, with DIF being a useful adjunct.</description><subject>Dermatology</subject><subject>Pathology</subject><issn>2168-8184</issn><issn>2168-8184</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNpVUUtLAzEQDqKo1N78AXv0YOvksbtZD0IpPgoVhVavYTedrdF0U5NNwX_v1hbR0wzffA-Gj5BzCsM8T4srHT3GMKQp53BAThnN5EBSKQ7_7CekH8I7AFDIGeRwTE64YDwFSk_J_NH59Zuzbml0aZPZGnXr4ypxdfKKwehoXRWtdTEksw_TJNMOdE24TkZNMmlCa9rYdkAnfUYftmqzwTNyVJc2YH8_e-Tl7nY-fhhMn-4n49F0oJmQ7QCFlJiljGW1TlHyqqLAIRVCYl3JjOl8UeNC5BKhKLK6gAp0LgvkZQEdR_Aeudn5rmO1woXGpvWlVWtvVqX_Uq406v-lMW9q6TZKMgFZvjW42Bt49xkxtGplgkZrywa7lxVLRZHJrAvtqJc7qvYuBI_1bwwFte1C7bpQP13wbyDTflg</recordid><startdate>20210530</startdate><enddate>20210530</enddate><creator>Ali, Javaria</creator><creator>Islam, Sabeeh</creator><creator>Ali, Syed Munqaad</creator><creator>Yaqeen, Syed Rafay</creator><creator>Aslam, Anum</creator><creator>Khan, Qurat ul ain</creator><creator>Malik, Umair Arshad</creator><creator>Irfan, Muhammad</creator><creator>Naqvi, Hanna</creator><creator>Hashmi, Atif A</creator><general>Cureus</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20210530</creationdate><title>Morphological Spectrum of Vesiculobullous Skin Lesions: An Institutional Perspective</title><author>Ali, Javaria ; Islam, Sabeeh ; Ali, Syed Munqaad ; Yaqeen, Syed Rafay ; Aslam, Anum ; Khan, Qurat ul ain ; Malik, Umair Arshad ; Irfan, Muhammad ; Naqvi, Hanna ; Hashmi, Atif A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c248t-e488e65226fc5e83bb10305448efb862c7dfed478e0996f90b0c789e3a9048e43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Dermatology</topic><topic>Pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ali, Javaria</creatorcontrib><creatorcontrib>Islam, Sabeeh</creatorcontrib><creatorcontrib>Ali, Syed Munqaad</creatorcontrib><creatorcontrib>Yaqeen, Syed Rafay</creatorcontrib><creatorcontrib>Aslam, Anum</creatorcontrib><creatorcontrib>Khan, Qurat ul ain</creatorcontrib><creatorcontrib>Malik, Umair Arshad</creatorcontrib><creatorcontrib>Irfan, Muhammad</creatorcontrib><creatorcontrib>Naqvi, Hanna</creatorcontrib><creatorcontrib>Hashmi, Atif A</creatorcontrib><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Curēus (Palo Alto, CA)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ali, Javaria</au><au>Islam, Sabeeh</au><au>Ali, Syed Munqaad</au><au>Yaqeen, Syed Rafay</au><au>Aslam, Anum</au><au>Khan, Qurat ul ain</au><au>Malik, Umair Arshad</au><au>Irfan, Muhammad</au><au>Naqvi, Hanna</au><au>Hashmi, Atif A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Morphological Spectrum of Vesiculobullous Skin Lesions: An Institutional Perspective</atitle><jtitle>Curēus (Palo Alto, CA)</jtitle><date>2021-05-30</date><risdate>2021</risdate><volume>13</volume><issue>5</issue><spage>e15330</spage><epage>e15330</epage><pages>e15330-e15330</pages><issn>2168-8184</issn><eissn>2168-8184</eissn><abstract>Introduction A vesiculobullous lesion of the skin encompasses a group of dermatological disorders with protean clinicopathological features. They usually occur as a part of the spectrum of various infectious, inflammatory, drug-induced, genetic, and autoimmune disorders. Therefore, accurate diagnosis of these lesions is essential for appropriate management and to reduce the associated morbidity and mortality. The conventional skin punch biopsy is the mainstay in the diagnosis of dermatological diseases, especially when combined with confirmatory tests, such as direct immunofluorescence (DIF). Our study evaluated the clinicopathological spectrum of vesiculobullous lesions. Methods We studied 150 cases of vesiculobullous lesions at the Department of Histopathology, Liaquat National Hospital and Medical College Karachi, Pakistan. Written and informed consent was taken from the patients followed by skin punch procedure in which three biopsies were obtained, which included one biopsy from the lesion and two peri-lesional biopsies. One peri-lesional biopsy was sent in cryomatrix for DIF studies, whereas the other two were sent in formalin to follow the standard tissue-processing protocol. Results Our results showed that most patients belonged to the geriatric age group of more than 50 years (44.7%), and 54.7% of the patients were females. Total 74.7% of the patients had generalized lesions, followed by lower limbs (9.3%) and trunk (7.3%) involvement. Most patients were diagnosed with bullous pemphigoid (31.3%), followed by pemphigus vulgaris (27.3%), dermatitis herpetiformis (15.3%), Darier’s disease (14.7%), pemphigus foliaceus (4.7%), epidermolysis bullosa (2%), linear immunoglobulin A dermatosis (2%), paraneoplastic pemphigus (0.7%), and drug reactions (0.7%). DIF studies were applied on 60 cases, out of which complement protein C3c was the most commonly deposited protein (53.3%). Conclusion Our study emphasized the diagnostic role of skin punch biopsy in the proper evaluation of vesiculobullous skin lesions. Histopathology is the cornerstone diagnostic tool in this regard, with DIF being a useful adjunct.</abstract><cop>Palo Alto (CA)</cop><pub>Cureus</pub><pmid>34235011</pmid><doi>10.7759/cureus.15330</doi><oa>free_for_read</oa></addata></record>
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title Morphological Spectrum of Vesiculobullous Skin Lesions: An Institutional Perspective
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