Garg Rashi, Bhojani Kaushal
Pandit Deendayal Upadhyay Medical College.
Maharishi Markandeshwar University Solan.
Afr Health Sci. 2020 Jun;20(2):885-890. doi: 10.4314/ahs.v20i2.42.
Vesicobullous lesions of skin may occur in different forms of dermatosis, which include various inflammatory, infective, autoimmune, drug induced as well as genetic conditions. Autoimmune bullous lesions, may be fatal if not treated with appropriate agents. Bearing in mind, the morbidity of these diseases, it is important to establish a firm diagnosis. A diagnostic skin biopsy with immunofluorescence is frequently used to confirm a clinical diagnosis, especially where it is not apparent clinically. There are many centres in India where immunofluorescence is not available and the diagnosis in these lesions is based on clinical and histopathological features only. Here in this study, we studied 53 skin punch biopsies with clinical suspicion of vesicobullous lesions followed by histopathological examination was carried out over a period of 2 years in a Medical College in Gujarat. Lesions were categorised based on the location of the blister. 1) Suprabasal 2) subcorneal 3) and subepidermal. Further subtyping was done based on additional histopathological features and clinical correlation. All the patients responded appropriately to the treatment and the results correlated well with the immunofluorescence done in a few cases. This study lays emphasis upon the histopathology and clinical features keeping in consideration of the lack of ancillary techniques in many centres especially in the developing world.
皮肤水疱大疱性病变可发生于不同类型的皮肤病，包括各种炎症性、感染性、自身免疫性、药物性以及遗传性疾病。自身免疫性大疱性病变若未用适当药物治疗可能会致命。鉴于这些疾病的发病率，明确诊断很重要。诊断性皮肤活检及免疫荧光检查常用于确诊临床诊断，尤其是在临床症状不明显的情况下。在印度有许多中心无法进行免疫荧光检查，这些病变的诊断仅基于临床和组织病理学特征。在本研究中，我们在古吉拉特邦的一所医学院对53例临床怀疑为水疱大疱性病变的皮肤穿刺活检进行了研究，随后在2年的时间里进行了组织病理学检查。病变根据水疱的位置进行分类。1）基底层上方；2）角质层下；3）表皮下。进一步的亚型分类基于额外的组织病理学特征和临床相关性。所有患者对治疗反应良好，结果与少数病例进行的免疫荧光检查相关性良好。考虑到许多中心尤其是发展中国家缺乏辅助技术，本研究强调了组织病理学和临床特征。
