Light microscopic finding in Pakistani children with chronic bullous disease of childhood

Abstract

Background Autoimmune blistering diseases, though uncommon in children, often pose adiagnostic dilemma in the absence of immunofluorescence techniques. Light microscopichistopathological features for chronic bullous diseases of childhood CBDC have beenadequately recorded in the literature but not for the Pakistani population.Objective This study aims at recording the histopathological features of children with CBDCin our population.Methods Light microscopic changes were recorded in 22 children with CBDC, diagnosed onthe basis of direct immunofluorescence findings.Results Of the 22 children that presented with CBDC, Strong linear IgA with or withoutother immunoglobulins deposition at the basement membrane zone was seen in 19 patients.Histopathology could be performed on 13 biopsy specimens of which 11 were suitable forreporting. Sections revealed a subepidermal blister in 81.8% specimens and papillary tipmicro abscesses in 45.5%. A predominantly neutrophilic infiltrate was also present in 54.6%of the specimenConclusion These findings show a strong overlap between the histological findings of mostpatients with CBDC and dermatitis herpetiformis, while the remaining CBDC patientsresemble those of bullous pemphigoid as far as the histology is concerned.