PMC5771739_01
Multiple tense vesiculobullae of dyshidrosiform pemphigoid, some of them hemorrhagic, on nonerythematous skin on the soles and the lateral surfaces of feet.
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When the patient presented to our clinic, multiple tense vesiculobullae (some hemorrhagic) on the nonerythematous skin of the palms, the soles, and lateral surfaces of both hands and feet were present (Fig 1).
Histopathologic findings show focal spongiosis tending to form focally subepidermal clefts and a predominantly eosinophilic dermal infiltration, consistent with bullous pemphigoid. (Hematoxylin-eosin stain; original magnification: x20.) A high-resolution version of this slide for use with the Virtual Microscope is available as eSlide: VM04193.
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The histopathologic finding revealed focal spongiosis tending to form focally subepidermal clefts and a predominantly eosinophilic dermal infiltration, which is consistent with early BP lesions (Fig 2).
Direct immunofluorescence of the perilesional skin shows continuous linear deposits of IgG along the dermoepidermal junction, consistent with bullous pemphigoid. Note the staining pattern of the blister roof within separate portions of biopsy, further supporting BP diagnosis.
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Direct immunofluorescence of the perilesional skin disclosed continuous linear deposits of IgG along the dermoepidermal junction and blister roof staining within separate portions of biopsy (Fig 3).