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Unusual direct immunofluorescence (DIF) pattern in pemphigus herpetiformis- A case report
Rawat Kavita1, Azad Sheenam1, Bahal Neelima1, Bisht S Jitender2
1 Department of Pathology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
2 Department of Dermatology, Venereology and Leprosy, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
Correspondence Address:
Azad Sheenam,
Department of Pathology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand
India
 Source of Support: None, Conflict of Interest: None DOI: 10.4103/IJPM.IJPM_879_20
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Pemphigus herpetiformis (PH) is an autoimmune intraepithelial bullous skin disorder. A 61-year-old female presented with history of multiple pruritic erosions, ulcers all over body, and diffuse loss of hair over scalp. Oral and genital mucosas were uninvolved. Subcorneal separation with suprapapillary thinning of epidermis, neutrophilic spongiosis, and elongation of rete ridges were seen on histopathology. Direct immunofluorescence (DIF) revealed IgG deposits in intercellular zone in fish net like pattern and focal linear IgA deposits along basement zone. Indirect immunofluorescence (IIF) revealed antibodies to desmoglein1 (Dsg-1) positive. A final diagnosis of PH was given. The patient responded well to treatment with dapsone and steroids.
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