RESUMEN
Background: Vesiculobullous disorders (VBDs) are extant with diverse clinical manifestations. Vesicles and bullae are fluid-filled cavities present within or beneath the epidermis. They are autoimmune blistering disorders in which autoantibodies are directed against target antigens present in the epidermis and dermo-epidermal junction. Objective: Evaluation of the various clinicodemographic profile of patients with a pattern of distribution (subtypes) of VBDs of the skin and assess the association between clinical aspects and histological changes in vesiculobullous lesions of the skin. Materials and Methods: The study material constituted 93 cases of VBDs out of 936 skin biopsies reported over two and a half years (January 2016 to June 2018) from the tertiary care center. A detailed history of the patients was taken, and a complete physical and dermatological examination with findings including clinical diagnosis was recorded. Histopathological examination (incisional/excisional/punch biopsy) was done in each case. The clinico-demographic evaluation was done and the results were correlated with histopathological findings. Results: Vesiculobullous lesions constituted 10.06% of all skin biopsies. The majority of cases were of pemphigus vulgaris (PV) 30 (32.25%) followed by 16 (17.2%) of bullous pemphigoid. In 83 cases (89.24%) histopathology findings were consistent with clinical diagnosis. Out of 34 cases that were diagnosed clinically as PV , the histopathological study proved 30 cases (88.23%) as PV. Conclusion: Vesiculobullous lesions of the skin are a heterogeneous group of disorders. It is essential to differentiate each pattern of subtype based on clinical examination and histopathological findings. Histopathological diagnosis with clinical correlation plays a major role in arriving at the diagnosis.
RESUMEN
Background: Tzanck smear named after Arnault Tzanck (1886-1954), to evaluate Cytopathology as a quick less invasive method for early diagnosis of bullous lesions. Aim: To determine the diagnostic value of Tzanck smear in vesiculobullous skin lesions, to evaluate the vesiculobullous lesions and correlating the diagnosis with Tzanck smears and histopathological findings and when required with Immmunoflourescence. Materials and methods: 565 patients clinically diagnosed as vesico-bullous skin lesions were included in the present study from July 2011 to July 2018 for a period of 7 years. Tzanck smear preparation and biopsy as well as immunoflouresence tests were done in all 565 patients. Results: Out of the 565 patients with vesiculo bullous lesions, 297 were males, and 268 were females. The concordant results between cytology and histopathology was observed in majority (92.7%) direct immunoflouresence test was done in some which also confirmed the diagnosis. Conclusion: The Tzanck smear test is an inexpensive, useful, and an easy diagnostic tool for vesiculo-bullous lesions of skin diseases and can be recommended as a bedside first line investigation.