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