A cross-sectional study of clinical and histopathological features of vesiculobullous skin lesions

Vesiculobullous diseases are a group of disorders in which primary lesion is a vesicle or a bulla involving skin and/or mucous membrane. It is important to identify and diagnose these lesions correctly as some of them are fatal if untreated. Hence, the present study was conducted to demonstrate various types of vesiculobullous lesions (VBL) and their histopathological features. Over a period of 20 months 35 skin biopsies from patients with vesiculobullous skin lesions were sent to the Department of Pathology. In all these cases, punch biopsies measuring 4-5 mm were taken and stained with Haematoxylin and Eosin (H&E) and examined under a light microscope for level of blister, alterations in the morphology of keratinocytes, epidermal changes and characteristics of inflammatory infiltrate. During the study period, 170 skin biopsies were obtained out of which vesiculobullous lesional biopsies were 35 (20.59%) in number. Clinical and histopathological correlation was demonstrated in 14 (82.35%) cases of Pemphigus vulgaris (PV), 8 (88.88%) cases of Bullous pemphigoid (BP), 4 (100%) cases of Pemphigus foliaceus (PF) and one case of Hailey Hailey disease (HHD). Dermatitis herpetiformis (DH), bullous systemic lupus erythematosus (BSLE), subcorneal pustular dermatosis (SCPD) and friction blister were diagnosed based on histopathological features alone. Four cases showed inconclusive results. A high level of accuracy can be obtained by correlating the clinical and histological findings in the diagnosis of vesiculobullous disorders.