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

Abstract

Background Autoimmune blistering diseases, though uncommon in children, often pose a
diagnostic dilemma in the absence of immunofluorescence techniques. Light microscopic
histopathological features for chronic bullous diseases of childhood CBDC have been
adequately recorded in the literature but not for the Pakistani population.
Objective This study aims at recording the histopathological features of children with CBDC
in our population.
Methods Light microscopic changes were recorded in 22 children with CBDC, diagnosed on
the basis of direct immunofluorescence findings.
Results Of the 22 children that presented with CBDC, Strong linear IgA with or without
other 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 for
reporting. Sections revealed a subepidermal blister in 81.8% specimens and papillary tip
micro abscesses in 45.5%. A predominantly neutrophilic infiltrate was also present in 54.6%
of the specimen
Conclusion These findings show a strong overlap between the histological findings of most
patients with CBDC and dermatitis herpetiformis, while the remaining CBDC patients
resemble those of bullous pemphigoid as far as the histology is concerned.