Linear Arrangement of Neutrophils Along the Basal Layer in Bullous Pemphigoid

Andrachuk, Lara; Ghazarian, Danny; Siddha, Sanjay; Habeeb, Ayman Al

doi:10.1097/dad.0b013e318222f951

Cited by 11 publications

(8 citation statements)

References 2 publications

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“…On the other hand, LAD is associated with a linear arrangement of neutrophils along the basal layer. 39 , 40 We observed neutrophils at the DEJ in 100% of our patients, and these neutrophils were mixed with eosinophils in 50.0% of cases ( Table 2 ; Figure 2 ). However, the presence of eosinophils may lead to a diagnostic confusion between LAD and BP.…”

Section: Discussionmentioning

confidence: 61%

“…37 , 38 A linear arrangement of eosinophils and neutrophils along the DEJ is not uncommon in the pemphigoid group, especially in PG. 39 We have noted a moderate-to-rich eosinophilic cell infiltration and tagging of eosinophils along the basal layer, which was observed in 54.5% and 40.0% of PG and BP patients, respectively ( Table 2 ; Figures 1 and 7 ). Infiltration of neutrophils into the DEJ was noted in 16% of BP patients, 8% of whom had lymphocytes ( Table 2 ).…”

Section: Discussionmentioning

confidence: 74%

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Histologic characterization of cellular infiltration in autoimmune subepidermal bullous diseases in a tertiary hospital in Saudi Arabia

BinJadeed¹,

Alyousef²,

Alsaif³

et al. 2018

CCID

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BackgroundAutoimmune subepidermal bullous dermatoses have similar clinical features to those of a spectrum of immune reactants at the dermoepidermal junction (DEJ). It is difficult to obtain a precise diagnosis without an immunofluorescence assay because of their similar clinical presentations. The aim of this study was to describe the cellular cutaneous infiltration among autoimmune subepidermal bullous dermatoses.Materials and methodsThis retrospective analysis was conducted at a hospital in Riyadh, Saudi Arabia using biopsy-based data collected from 65 patients.ResultsSpongiotic changes, neutrophils, and lymphocyte infiltrations in the epidermis differed among the subepidermal bullous diseases. The DEJ showed a difference in the extent of neutrophil infiltration. The dermis showed differences in perivascular lymphocytic infiltration, neutrophilic infiltration, eosinophilic infiltration, and dermal edema.ConclusionThe dermal and DEJ showed most of the histopathologic changes in subepidermal autoimmune bullous dermatoses.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 74%

Histologic characterization of cellular infiltration in autoimmune subepidermal bullous diseases in a tertiary hospital in Saudi Arabia

BinJadeed¹,

Alyousef²,

Alsaif³

et al. 2018

CCID

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“…38,39 Neutrophil-predominant BP was recognized as a rare histological variant of BP. 40,41 However, the real prevalence of this variant and its associated morphological and immunological features were not systematically assessed. Investigating a relatively large cohort of patients with BP, we found that 12.3% of our patients had neutrophil-predominant infiltrations.…”

Section: Discussionmentioning

confidence: 99%

The impact of lesional inflammatory cellular infiltrate on the phenotype of bullous pemphigoid

Ständer

Hammers

Vorobyev

et al. 2021

Acad Dermatol Venereol

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Background The influence of cutaneous cellular infiltration on the phenotype of bullous pemphigoid (BP) remains to be established.Objectives To evaluate the main histopathological characteristics of patients with BP and to assess the association between the composition of lesional inflammatory infiltrate and the various clinical, immunological and immunopathological aspects of the disease. MethodsRetrospective study encompassing patients diagnosed with BP throughout the years 2009-2020 in a specialized tertiary referral centre. ResultsThe study encompassed 136 patients with BP, of whom 27 (19.9%) demonstrated a cell-poor inflammatory infiltrate in lesional skin specimens. Overall, 78 (57.4%), 71 (52.2%) and 5 (3.7%) specimens were found to include eosinophil-predominant, lymphocyte-predominant and neutrophil-predominant inflammatory infiltrates, respectively.Relative to the remaining patients with BP, those with an eosinophil-predominant inflammatory infiltrate had higher (90.8% vs. 77.2%; P = 0.030) whilst those with a cell-poor inflammatory infiltrate lower (70.3% vs. 88.7%; P = 0.017) seropositivity of anti-BP180 NC16A IgG. The latter subgroup presented with higher prevalence of mucosal involvement (25.9% vs. 8.3%; P = 0.011) and a non-inflammatory clinical phenotype (50.0% vs. 17.1%; P = 0.041). Patients with lymphocyte-predominant inflammatory infiltrate manifested with higher severity BPDAI scores and a lower frequency of the non-inflammatory subtype (11.1% vs. 36.4%; P = 0.035), whilst those with a neutrophilic infiltrate presented with lower mean (SD) levels of anti-BP180 NC16A IgG [269.3 (227.6) vs. 722.7 (1499.6) U/mL; P = 0.003].Conclusions Eosinophil-predominance and high cellularity in the lesional inflammatory infiltrate of BP skin are associated with increased seropositivity of anti-BP180 NC16A IgG. Lymphocyte-predominant infiltrates predict a more severe phenotype, pointing towards a pathogenic role of autoreactive lymphocytes.

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“…Predominant neutrophils of subepidermal blisters in bullous pemphigoid are very rare histological findings. Lara Andrachuk [15] reported a case of a 59-year-old woman with bullous eruption, and the histologic examinations of her skin lesions showed subepidermal blisters with linear arrangement of neutrophils. He suggested that bullous pemphigoid should be considered in the differential diagnosis of neutrophil-rich subepidermal bullous disease with dermatitis herpetiform and LABD.…”

Section: Journal Of Clinical and Experimental Dermatology Researchmentioning

confidence: 99%

Childhood Bullous Pemphigoid: A Case Report and Literature Review

Chou¹

2014

J Clin Exp Dermatol Res

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Linear Arrangement of Neutrophils Along the Basal Layer in Bullous Pemphigoid

Cited by 11 publications

References 2 publications

Histologic characterization of cellular infiltration in autoimmune subepidermal bullous diseases in a tertiary hospital in Saudi Arabia

Histologic characterization of cellular infiltration in autoimmune subepidermal bullous diseases in a tertiary hospital in Saudi Arabia

The impact of lesional inflammatory cellular infiltrate on the phenotype of bullous pemphigoid

Childhood Bullous Pemphigoid: A Case Report and Literature Review

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