Intraepidermal IgG deposition is seen in –
Correct Answer: Pemphigous
Description: Ans. is 'a' i.e., Pemphigus * Bullae and vesicles are formed due to a collection of fluid in the skin and the fluid collection occurs at sites where the cohesion of the skin is weak i.e.SubcornealIntraepidermal due to the separation of individual keratinocytesDermo-epidermal junctionClassification of bullous disorders based on the level of bullaeSubcornealIntra-epidermalDermoepidermalBullous impetigoStaphylococcal scalded skin syndromeMiliaria crystallineSubcorneal pustular dermatosisEczemasViral infectionsPemphigus group of childhoodEpidermolysis bullosaPemphigoidChronic bullous disease Dermatitis herpetiformisToxic epidermal necrolysisEpidermolysis bullosaBullous erythema multiformCharacteristics of BullaeSubcorneal bullaIntraepidermal bullaDermoepidermal bullaLocated below stratum corneumBullae is fragile and ruptures easilyContains clear fluid / pusOn rupturing, seal crust forms no erosion is formedIn prickle cell layerTakes time to ruptureClear fluid / pus Crusted erosionsAt dermoepidermal junctionPersistent bullaeHemorrhagic fluidHemorrhagic crusts on ulcersLaboratory investigations Tzanck smear * This is a quick bedside test done in bullous lesions after rupturing a fresh blister. The roof is detached, the floor of the lesion is scraped using a scalpel blade and the material so obtained spread on a glass slide and stained with Giemsa or any of the Romanowsky's stains.Tzanck smear findings in bullous disordersDisordersFindings* PemphigusAcantholytic cells* Bullous pemphigoidPredominantly eosinophils* Chronic bullous disease of childhoodPredominantly polymorphs* Varicella-zoster infectionMultinucleate giant cells* Herpes simplex infectionMultinucleate giant cells* Toxic epidermal necrolysisNecrotic cells
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