 Site created by Dr Sampurna Roy MD
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Dr Sampurna Roy
MD
Surgical-Pathology.com
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Vesiculobullous reaction pattern is characterized by the presence of vesicles or bullae at any level within epidermis or at the dermoepidermal junction. These lesions may be acquired or congenital and result from a defect in the adhesion of keratinocytes.
The three main features that should be assessed in a case of vesiculobullous lesion:
1. Anatomical level of the split ; 2. Mechanism responsible for the split ;
3. Inflammatory cellular component.
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SUBCORNEAL SPLIT:
-Impetigo
-Pemphigus erythematosus |
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INTRAEPIDERMAL SPLIT
-Severe spongiotic dermatitis |
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SUPRABASAL SPLIT -Pemphigus vulgaris 
-Darier's disease -Grover's disease -Hailey- Hailey disease
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SUBEPIDERMAL SPLIT WITH LITTLE
INFLAMMATION -Epidermolysis bullosa
-Bullous pemphigoid -Porphyria cutaneous tarda -Toxic epidermal necrolysis |
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SUBEPIDERMAL SPLIT
WITH EOSINOPHILS -Bullous pemphigoid
-Herpes gestationis -Arthropod bite -Drug reaction |
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SUBEPIDERMAL SPLIT
WITH MAST CELLS -Bullous urticaria pigmentosa |
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SUBEPIDERMAL SPLIT
WITH NEUTROPHILS -Dermatitis herpetiformis
-Linear IgA bullous dermatosis -Cicatricial pemphigoid -Bullous urticaria -Bullous SLE |
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SUBEPIDERMAL SPLIT WITH LYMPHOCYTES -Erythema Multiforme -Bullous fixed drug eruption -Fungal infection -Lichen planus pemphigoides -Polymorphous light eruption |