Cutaneous Autoimmune Blistering Disease .

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Cutaneous rankle. Aftereffect of huge spongiosis, balloning degeneration, basal vacuolopathy, acquired issue or immune system destructionHistology, DIF and clinical history to touch base at the right conclusion. Case 1. 24 y/o dark lady with strained 2-3 cm liquid filled rankle on the furthest point, joint agony and swellingHx of SLE advancement to include the brow and lower extremityLM: subepide
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Cutaneous Autoimmune Blistering Disease ~ Pathology Case Review ~2004, March/Aprial

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Cutaneous rankle Result of noteworthy spongiosis, balloning degeneration, basal vacuolopathy, acquired turmoil or immune system demolition Histology, DIF and clinical history to land at the right determination

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Case 1 24 y/o dark lady with tense 2-3 cm liquid filled rankle on the furthest point, joint agony and swelling Hx of SLE advance to include the temple and lower limit LM: subepidermal rankle with a thick neutrophilic penetrate

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Case 1 DIF: straight Ig G, IgA and IgM testimony along the BM IIF: affidavit along the floor of the skin

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Case 1 Beyond the instrument of disturbance, the levels of partition and the kind of provocative reactions help to additionally portray the procedure Confirmation of autoantibody statement: DIF, IIF, immunoblot, immunoprecepitation Immnoelerctorn microscopy Salt split skin : subepidermal rankling dx

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Porphyria cutanea tarda(PCT) Sun uncovered destinations Paucicellular subepidermal rankle Reduptication of the vascular and epidermal cellar film DIF: IgG and C3 caught in vascular divider

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Epidermolysis bullosa acquisita (EBA) Blister on acral and injury inclined destinations DIF: IgG and C3 statement along the floor of detachment Other D/D: urticarial variation of BP, suction rankle, rankle because of cryotherapy or warmth, acquired epidermolysis bullosa variation, TEN

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Bullous pemphigoid(BP) Over 60 y/o, bullae on the storage compartment and limit Subepidermal rankle with fiery invade( dominating eosinophil) DIF: direct IgG along the BM IIF: statement on the rooftop

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Dermatitis herpetiformis(DH) Adult with an endless pruritic emission Strong hereditary inclination DIF: IgA and C3 in the tip of dermal papilla

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Linear IgA dermatosis Childhood and grown-up sort DIF confined to the dermal papilla as well as along the dermal epidermal intersection

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Cicatrical pemphigoid(CP) Oral and conjuctival rankle in elderly p\'t autoAb: coordinate against BPAg2 of the hemidesmosome, dpiligrin in the lamina densa and sort VII collagen

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Bullous systemic lupus erythematosus(BSLE) A phenomenal indication of SLE PMN more profound in the papillary dermis and around vessel DIF: direct or granular statement of IgG and supplement along the BM Direct against collagen VII

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Case (2) 38 y/o man with broad agonizing disintegrations of the lip and tongue Polymopphous lichenoid plaque, LAPs LM: basal vaculopathy with a suprabasal rankle, lymphocyte exocytosis, keratinocyte putrefaction, suprabasal acantholysis DIF: BM, intercellar deposistion IgG

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Pemphigus foliaceous(PF) Subcorneal bilster on the head and neck Never include mucosal surface Ab to desmoglein DIF: IgG fishnet design

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Pemphigus erythematosus Well-surrounded sores on the malar zone DIF: IgG,C3 in both BM and intercelluar 30% positive ANA and related with other immune system sickness

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Pemphigus vulgaris(PV) Painful oral ulcer Blister and no more basal layer of the epidermis, loss of cell-cell bond with upkeep of connection to the BM DIF: IgG, C3 on the keratinocyte, Ab to desmoglein

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Paraneoplastic pemphigus(PNP) Occurs solely in the neoplasm Complex arrangement of autoAb to at least one proteins that assume enter parts in cell-cell grip Significant fluctuation in histologic elements IIF:intercelluar recoloring

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Other D/D Acute spongiosis, viral contamination, Hailey-Hailey illness, Darier ailment, Grover ailment, contact rankle

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Summary Cutaneous immune system bilstering dx have many covering clinical and histological elements and depend on clinicopathological relationship The level or division, the kind of incendiary penetrate and IF design nonAb intervened interceded handle

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Our experience

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Other: epidermolysis bullosa simplex EBA EM Lichen arranges pemphgioids Bullousis diabeticum H.P. purpura Bullous amyloidosis Granuloma faciala Pigmented purpura dermatosis

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