Huma Ali Asghar, Tahir Saeed Haroon, Muhammad Jahangir, Tariq Zaman.
A Study of Histological Features of Pemphigus.
J Coll Physicians Surg Pak Jan ;12(5):282-6.

Objective: To analyze diagnostic patterns of Pemphigus and to assess the sensitivity of histopathology as its diagnostic tool. Design: Prospective observational study. Place and Duration of Study: Department of Dermatology, King Edward Medical College / Mayo Hospital, Lahore over a period of one year. Subjects and Methods: Histopathological examination of haematoxylin-eosin stained slides of skin biopsies from 50 patients with active Pemphigus (diagnosed on the basis of positive direct Immunofuorescence). Results: There were 36 patients (72%) with deep Pemphigus {33 (66%) Pemphigus vulgaris, 3 (6%) Pemphigus vegetans)} and 14 (28%) with superficial Pemphigus (all 14 Pemphigus foliaceus). The major histological features of Pemphigus vulgaris were supra-basal (16 or 48%) or intraspinous (6 or 18%) clefting, acantholysis (24 or 73%), and tombstoning of basal cells (16 or 48%). In Pemphigus vegetans acanthosis (3 or 100%), papillomatosis (3 or 100%), and acantholysis (2 or 67%) were seen. In Pemphigus foliaceus superficial clefting (12 or 86%) and acantholysis (11 or 79%) were seen. Conclusion: The sensitivity of histology was 76% (75% for deep Pemphigus and 79% for Pemphigus foliaceus) with a single biopsy specimen.

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