Eosinophilic spongiosis. A CLINICAL HISTOLOGICAL AND IMMUNOFLUORESCENT CORRELATION

Abstract

Summary This report gives an account of nine patients, all females, with the histological finding of eosinophilic spongiosis. Six of them had positive intercellular antibodies on direct immunofluorescence but only two had circulating pemphigus antibodies. The clinical presentations of those with proven pemphigus resembled bullous pemphigoid in one, dermatitis herpetiformis in another, whereas the remainder were more typical of pemphigus foliaceus or vulgaris. Three patients had negative immunofluorescence. They may still develop pemphigus or alternatively could have some unclassifiable bullous dermatosis.

Clinical and histopathological features of pemphigus foliaceus with and without eosinophilic infiltrates: a retrospective evaluation of 40 dogs

“…The clinical importance of specific tissue cell populations has been investigated as a diagnostic tool, mechanism of pathogenesis and prognostic indicator in humans. [12][13][14][15][16][17][18][19][20][21][22][23][24][25] These studies demonstrate the importance of classifying and quantifying cellular tissue infiltrates. However, to the authors' knowledge, this is the first study to evaluate the cellular infiltrate at different microanatomic locations in canine PF, and to compare different cellular infiltrates with clinical features and outcomes.…”

“…[15][16][17] The presence of eosinophils and neutrophils within the epidermis may be recognized as the first indication of immunobullous and other inflammatory dermatological disorders in people. 18,19 In addition, analyses of chemotactic cytokines in blister fluid and sera have been correlated with the character of the cellular infiltrate in people with autoimmune blistering diseases. [20][21][22] Such patterns of inflammation and specific types of infiltrating cells can provide valuable clinical, prognostic and diagnostic information to the clinician.…”

Eosinophilic spongiosis in association with bullous pemphigoid and chronic lymphocytic leukaemia

“…It is now an accepted early histopathological feature of several bullous diseases, especially in their early stages, and more commonly in those with an unusual clinical presentation, such as pemphigus herpetiformis. 3 ES is often seen adjacent to areas of acantholysis or subepidermal blister formation. It may also be the sole or predominant histological feature.…”

Eosinophilic spongiosis: a localized bullous dermatosis unassociated with pemphigus

“…Clinical presentation was variable, the appearances often suggesting pemphigus foliaceus or pemphigus vtilgaris, but also closely simulating other builous dermatoses, particularly dermatitis herpetiformis. Knight et al (1976) added nine cases of their own and reviewed seven other published cases in which immunopathoiogical data were available. For all except three of their own cases they showed that the histological finding of eosinophilic spongiosis was associated with the characteristic intercellular antibody of pemphigus.…”

“…The three cases described by Knight et aL (1976) in which immunofluorescence was negative were a 49-year-old woman with a severe bullous eruption simulating erythema multiforme; an 82-year-old woman with widespread turgid erythematous plaques, which cleared spontaneously after a few weeks; and an itchy herpetiform eruption on the trunk which was associated with polycythaemia rubra vera (PRV) (Black, 1977). Two other cases of eosinophilic spongiosis apparently associated with PRV have been published (Strickler, 1945;Fry, 1965), and although immunofluorescence techniques were unavailable at the time they were reported, from the data provided it is unlikely that the cases had pemphigus.…”