Clinico histopathological Characteristics and Immunofluorescent Studies of Bullous pemphigoid in Anatomical Pathology Department, Cipto Mangunkusumo General Hospital within 2011-2018

Abstract

Background
Bullous pemphigoid is the most common autoimmune bullous disease. It is characterized by the presence of autoantibodies against
hemidesmosomal proteins in dermo-epidermal junction. Immune complexes subsequently induce skin blisters formation clinically, which will
appear as subepidermal cleft histopathologically, and revealed as immune depositions immunologically. These three findings are required in
order to estabilsh the diagnosis of Bullous pemphigoid. This study was aimed to asses the clinico histopathological characteristics and
immunofluorescence studies of bullous pemphigoid in Anatomical Pathology Department, Cipto Mangunkusumo General Hospital.
Methods
A cross sectional study was conducted in Anatomical Pathology Department ,Cipto Mangunkusumo General Hospital from January 2011 to
December 2018. Clinical, histopathological, and direct immunofluorescence results were evaluated.
Results
During the last 8 years, bullous pemphigoid was the second most common form of autoimmune bullous diseases. The mean age of the
sample was 60 years old. Women were affected more common than men (61.6%). Majority of patients present with blisters eruption (67.4%)
and most commonly found in the lower extremities (48.8%). Histopathological examinations showed mostly a subepidermal cleft (89.5%)
containing infiltrates of eosinophil, neutrophil, and lymphocyte. DIF staining demonstrated 31 cases (36.0%) with immune deposits
characteristic for bullous pemphigoid.
Conclusion
The diagnosis of bullous pemphigoid is relied on a combination of clinical, histopathological, and direct immunofluorescence findings.