Study of vesicobullous lesions of the skin clinical and histopathology correlation

Introduction: Vesiculobullous diseases are a group of disorders in which primary lesion is a vesicle or a bulla on the skin or mucous membrane or both. Though some of the veisculobullous lesions are characteristics in their appearance and distribution, clinically many a times a definitive diagnosis cannot be made by physical examination alone. Then the dermatologists are forced to resort to histopathology for a definite diagnosis and classification. In the present scenario, even though histopathological study is sufficient in most of the cases, it is often accompanied by immunofluorescence antibody tests for confirmation of the diagnosis and monitoring of the disease. Direct immunofluorescence antibody test is a gold standard to confirm the disease and the indirect test helps to monitor the disease. Objectives: This study was carried out to find out clinical and histopathological correlation in diagnosing the disease. Materials and Methods: In the present study, histopathological evaluated vesiculobullous lesions over the period of 2 years. A total number of 35 cases were encountered. Staining procedures done are haematoxylin – eosin staining, leishmann staining and direct immunofluorescence stain. Results: A total number of 35 cases were encountered which constituted 0.70% of overall biopsy specimen and 12.32% of skin biopsy specimen. The pemphigus vulgaris formed commonest disease encountered accounting for 34.30% of all skin lesions. Bullous pemphigoid formed the second most common disease observed (31.34%) affecting both sexes equally. Conclusions: All though the ‘primary' vesiculobullous lesions of skin are seen in a small group of people, they have been associated with significant a morbidity and mortality. It is important to distinguish each of these entities and separate them appropriate for management and treatment. Even though clinical examination has its own importance, both histopathological and DIF testing is must, as it confirms the diagnosis and subtyping.