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Vesiculobullous Reaction Pattern in Dermatopathology

Dr Sampurna Roy MD

 

                                                                                                                      

 

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.

 

Subcorneal Split 

- Impetigo

-Pemphigus Foliaceus

-Pemphigus Erythematosus 

-Subcorneal Pustular Dermatosis  Dermatopathology Quiz Case 92  

-Staphylococcal Scalded Skin Syndrome

 

Intradermal Split 

- Spongiotic blistering disease

- Viral blistering disease - Example: Herpes Infection

- Palmoplantar pustulosis

 

Suprabasal Split 


-Pemphigus vulgaris 

-Darier's disease Dermatopathology Quiz Case 111   

-Grover's disease Dermatopathology Quiz Case 71

-Hailey-Hailey Disease ;   Dermatopathology Quiz Case 46

 

 

Subepidermal Split with little Inflammation

-Epidermolysis bullosa 

-Bullous pemphigoid

-Toxic epidermal necrolysis

 

Subepidermal Split with Eosinophils 

 

   

 Histopathology Images of Bullous Pemphigoid


-
Bullous Pemphigoid

-Herpes gestationis

-Arthropod bite 

-Drug reaction  

 

Subepidermal Split with Neutrophils

 



-Dermatitis herpetiformis
Dermatopathology Case 37

-Linear IgA bullous dermatosis

-Cicatricial pemphigoid

-Bullous SLE

 

 Subepidermal split with Lymphocytes 



-Erythema Multiforme  Dermatopathology Case 57 

-Bullous fixed drug eruption  Dermatopathology Quiz Case 58

-Fungal infection

-Polymorphous light eruption

 

 

Subepidermal Split with Mast cell 

-Bullous urticaria pigmentosa

 

 

 

 

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)


 

 

 

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