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Original Research

RMJ. 2018; 43(3): 401-404

A cross-sectional study of clinical, histopathological and direct immunoflorescence diagnoses in common immunobullous disorders

Humaira Talat, Mohammad Mubarak, Shaheera Shakeel, Zarnaz Wahid, Saba Majeed, Tayyaba Iqbal.

Objective: To correlate clinical, histopathological and direct immunofluorescence findings of common immunobullous disorders.
Methodology: A cross sectional study, in which 34 patients were included by non probability consecutive sampling technique in a period of 2 years from January 1, 2015 to December 31, 2016. Patients aged one to 70 years, visiting dermatology department, Civil Hospital Karachi, were examined by a dermatologist to make a provisional diagnosis of a specific Immunobullous disorder clinically. Biopsies were done for histopathological findings on light microscopy and direct immunofluorescence (DIF).
Results: Mean age of patients was 40.29±SD years. Clinical examination revealed pemphigus vulgaris (61%) to be the most common type of immunobullous disorders followed by bullous pemphigoid disease (8.8 %). Pemphigus foliaceus, Pemphigus vegetans, Epidermolysis bullosa acquisita (EBA), Linear IgA disease and Dermatitis herpetiformis constituted 5.8%, for each. A positive correlation and 100% concordance was seen between clinical features, light microscopy and DIF findings in all cases except for 2 cases of Epidermolysis bullosa acquisita, where DIF was negative.
Conclusion: Proper clinical assessment retains paramount importance while diagnosing immunobullous disorders. Histopathology and direct FIF are the most important helping tools for confirmation.

Key words: Immunobullous disorders, pemphigus, bullous pemphigoid, Linear IgA disease, Epidermolysis bullosa acquisita, dermatitis herpetiformis, direct immunofluorescence.

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