The differential diagnosis of vesiculobullous lesions can be intimidating to the primary care provider. While some entities such as bullous impetigo may easily be diagnosed clinically if the patient's demographics as well as the lesion morphology and distribution present classically, atypical presentations may require additional laboratory studies for confirmation. We describe a case of bullous impetigo with characteristics that clinically mimicked two rare immunobullous dermatoses. Although extensive diagnostic testing was performed, we recommend an approach for primary care providers to initiate empiric treatment while maintaining awareness of less common immunobullous entities.
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http://dx.doi.org/10.1093/milmed/usab475 | DOI Listing |
Dermatopathology (Basel)
December 2024
Department of Pathology, University of Virginia, Charlottesville, VA 22903, USA.
The diagnostic utility of immunohistochemistry on paraffin-embedded sections in bullous disorders is useful when frozen tissue is not available. In pemphigus vulgaris and pemphigus foliaceus, an intercellular lace-like staining pattern of IgG4 on lesional tissue by immunohistochemistry has been described, with a comparable sensitivity and specificity to direct immunofluorescence on perilesional tissue. This study aimed to evaluate the staining pattern of IgG4 in non-immunobullous disorders to highlight the potential pitfalls when using this stain.
View Article and Find Full Text PDFSemergen
December 2024
Department of Dermatology, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Instituto de Investigación Sanitaria (IIS) La Fe, Valencia, Spain.
FP Essent
June 2024
Department of Family and Community Medicine, University of Texas Health, San Antonio.
Vis J Emerg Med
July 2023
West Los Angeles Veterans Affairs Medical Center, Los Angeles, CA, USA.
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