Patterns of periodic acid–schiff staining in subepidermal bullous disorders with emphasis on bullous pemphigoid
Background: Direct immunofluorescence (DIF) including salt split skin technique is quintessential in the diagnosis of subepidermal bullous disorders. These techniques are expensive and require technical expertise, limiting their diagnostic utility. The property of periodic-acid–Schiff to stain the b...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-01-01
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| Series: | Current Medical Issues |
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| Online Access: | http://www.cmijournal.org/article.asp?issn=0973-4651;year=2024;volume=22;issue=1;spage=1;epage=6;aulast=Ponmar |
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| author | Madhurima Ponmar Dharshini Sathishkumar Susanne Alexander Pulimood Meera Thomas |
| author_facet | Madhurima Ponmar Dharshini Sathishkumar Susanne Alexander Pulimood Meera Thomas |
| author_sort | Madhurima Ponmar |
| collection | DOAJ |
| description | Background: Direct immunofluorescence (DIF) including salt split skin technique is quintessential in the diagnosis of subepidermal bullous disorders. These techniques are expensive and require technical expertise, limiting their diagnostic utility. The property of periodic-acid–Schiff to stain the basement membrane and the patterns produced by it was observed in a cohort of subepidermal bullous disorders, to see if it offers an alternative cost-effective testing method. Materials and Methods: This was a retrospective, observational study conducted in the department of general pathology, in a tertiary care medical center, over a period of 4 years. Only those cases for which paraffin sections, DIF and direct salt split skin immunofluorescence technique were available were included. The levels of anti-bullous pemphigoid (BP) antibodies were collected where available. Results: Of the 21 cases analyzed, 15 were BP, two each of epidermolysis bullosa acquisita (EBA) and lichen planus pemphigoides (LPP), one each of porphyria cutanea tarda (PCT), and bullous systemic lupus erythematosus (SLE). All the cases of BP, LPP and EBA showed a floor pattern of staining with periodic acid–Schiff (PAS) stain. Roof pattern of staining was observed in bullous SLE and PCT. PAS was found to be useful in diagnosing BP, especially in conjunction with an eosinophil rich bulla and anti-BP antibodies. Conclusion: We found that PAS stain could be an adjunct to hematoxylin and eosin stain when the diagnosis of BP is in doubt. However, larger sample size is needed to study its utility in other subepidermal bullous disorders. |
| first_indexed | 2024-03-07T23:01:25Z |
| format | Article |
| id | doaj.art-b3ac346d00ac4d84aa40007570010c2d |
| institution | Directory Open Access Journal |
| issn | 0973-4651 2666-4054 |
| language | English |
| last_indexed | 2024-03-07T23:01:25Z |
| publishDate | 2024-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Current Medical Issues |
| spelling | doaj.art-b3ac346d00ac4d84aa40007570010c2d2024-02-22T14:43:22ZengWolters Kluwer Medknow PublicationsCurrent Medical Issues0973-46512666-40542024-01-012211610.4103/cmi.cmi_69_23Patterns of periodic acid–schiff staining in subepidermal bullous disorders with emphasis on bullous pemphigoidMadhurima PonmarDharshini SathishkumarSusanne Alexander PulimoodMeera ThomasBackground: Direct immunofluorescence (DIF) including salt split skin technique is quintessential in the diagnosis of subepidermal bullous disorders. These techniques are expensive and require technical expertise, limiting their diagnostic utility. The property of periodic-acid–Schiff to stain the basement membrane and the patterns produced by it was observed in a cohort of subepidermal bullous disorders, to see if it offers an alternative cost-effective testing method. Materials and Methods: This was a retrospective, observational study conducted in the department of general pathology, in a tertiary care medical center, over a period of 4 years. Only those cases for which paraffin sections, DIF and direct salt split skin immunofluorescence technique were available were included. The levels of anti-bullous pemphigoid (BP) antibodies were collected where available. Results: Of the 21 cases analyzed, 15 were BP, two each of epidermolysis bullosa acquisita (EBA) and lichen planus pemphigoides (LPP), one each of porphyria cutanea tarda (PCT), and bullous systemic lupus erythematosus (SLE). All the cases of BP, LPP and EBA showed a floor pattern of staining with periodic acid–Schiff (PAS) stain. Roof pattern of staining was observed in bullous SLE and PCT. PAS was found to be useful in diagnosing BP, especially in conjunction with an eosinophil rich bulla and anti-BP antibodies. Conclusion: We found that PAS stain could be an adjunct to hematoxylin and eosin stain when the diagnosis of BP is in doubt. However, larger sample size is needed to study its utility in other subepidermal bullous disorders.http://www.cmijournal.org/article.asp?issn=0973-4651;year=2024;volume=22;issue=1;spage=1;epage=6;aulast=Ponmarbullous pemphigoidperiodic acid–schiffsubepidermal bullous disorders |
| spellingShingle | Madhurima Ponmar Dharshini Sathishkumar Susanne Alexander Pulimood Meera Thomas Patterns of periodic acid–schiff staining in subepidermal bullous disorders with emphasis on bullous pemphigoid Current Medical Issues bullous pemphigoid periodic acid–schiff subepidermal bullous disorders |
| title | Patterns of periodic acid–schiff staining in subepidermal bullous disorders with emphasis on bullous pemphigoid |
| title_full | Patterns of periodic acid–schiff staining in subepidermal bullous disorders with emphasis on bullous pemphigoid |
| title_fullStr | Patterns of periodic acid–schiff staining in subepidermal bullous disorders with emphasis on bullous pemphigoid |
| title_full_unstemmed | Patterns of periodic acid–schiff staining in subepidermal bullous disorders with emphasis on bullous pemphigoid |
| title_short | Patterns of periodic acid–schiff staining in subepidermal bullous disorders with emphasis on bullous pemphigoid |
| title_sort | patterns of periodic acid schiff staining in subepidermal bullous disorders with emphasis on bullous pemphigoid |
| topic | bullous pemphigoid periodic acid–schiff subepidermal bullous disorders |
| url | http://www.cmijournal.org/article.asp?issn=0973-4651;year=2024;volume=22;issue=1;spage=1;epage=6;aulast=Ponmar |
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