Clinicopathological correlation of blistering diseases of skin

Blistering diseases are alarming skin conditions where blister formation occurs in various ways and cannot be differentiated clinically. For confirmation of diagnosis, along with routine histological examination, immunofluorescence study is essential. Tzanck smear may be used as a rapid diagnostic tool. We included here 34 cases of different blistering lesions. Other than routine Hematoxylin & Eosin stain, direct immunofluorescence test was done in 31 cases, indirect immunofluorescence in 28 cases and Tzanck smear in 33 cases. Direct immunofluorescence stain was also applied on Tzanck smears. The most frequent diagnoses were pemphigus (n=16), bullous pemphigoid (n=11) and linear IgA dermatosis (n=3). Clinical findings and histological examination were sufficient for the diagnosis of most cases. Direct immunofluorescence study is essential in many cases, and indirect immunofluorescence study is a useful method for diagnosis of some of the blistering diseases, especially in pemphigus. Direct immunofluorescence staining on Tzanck smear is a novel technique for the diagnosis of pemphigus