How Can a Dermatopathologist Help Me?
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Blisters are not always associated with burns!
All of us have experienced the pain of a blister, whether it is from ill-fitting shoes or a misguided attempt to toss an omelet. While these blisters may sometimes be quite serious requiring medical attention, most cases can be handled with simple first aid.
However, there are blisters that may portend a more serious prognosis and may require immediate and long term medical care and attention. Two of these diseases are bullous pemphigoid and pemhigus vulgaris. Bullous pemphigoid may present with tense blisters, usually on a reddened skin base. Pemphigus vulgaris may present with flaccid blisters, with the skin ulcerated or sloughed. Pemphigus, in particular, may also present with blisters on other areas of the body including the mouth and other mucous membranes.
While the diagnosis may be strongly suspected by clinical examination, a biopsy is needed to confirm the diagnosis. There are distinctive changes the dermatopathologist looks for to establish the diagnosis. In addition, working with your dermatologist or other physician, the dermatopathologist may order a specialized test known as direct immunofluorescence. In this latter analysis, antibodies are tagged with a fluorescent marker and are applied to the skin biopsy tissue. The biopsy is then examined under a fluorescent microscope. In the photomicrograph above, the tagged antibody is staining positive in the region between the epidermis and dermis, helping to confirm the diagnosis of bullous pemphigoid.
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Medical Terms You Should Know
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What is a Vesicle or a bullae?
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