Fibroepithelioma of Pinkus
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News about Skin Diseases From a Microscopic Eye!
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Feature Article
How Can a Dermatopathologist Help Me?
Medical Terms You Should Know
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Pemphigus Support Group
Pemphigus vulgaris
Blisters may represent a reaction to an irritant but may rarely represent an underlying systemic disease that requires immediate medical attention. The International Pemphigus and Pemphigoid Foundation provides helpful information and a patient support network.

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February 2009

The Dermatopathology Institute analyzes the current stories making headlines in dermatology with a viewpoint from the microscope, helping you to truly understand all of the nuances of the disease.

We hope some of you were able to attend our community and hospital presentations.

Malignant Melanoma-The Role of the Dermatopathologist. (Presented at Bread of Life Church, Torrance, CA. February 22, 2009)

Seven Things You Should Not Say at a Dermatopathology Conference. (Presented to Kaiser Woodland Hills Pathology Department, February 17, 2009)

Thank you!
The Dermatopathology Institute
How Can a Dermatopathologist Help Me?
Bullous pemphigoid DIF 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.
Medical Terms You Should Know
Atopic Dermatitis What is a Vesicle or a bullae?

The two terms are often used interchangeably and may simultaneously occur in a patient. Both are blisters. The strict medical definition of a bulla is a blister that is more than 5mm in diameter (about 3/16 of an inch). Anything less than this is a vesicle.

Additional Links

The Doctor's Doctor-Bullous Pemphigoid

The Doctor's Doctor-Pemphigus Vulgaris

The Doctor's Doctor-Skin Rashes

The Doctor's Doctor-Basic Principles of Disease
Thank you for taking the time to visit with us.

We hope you have gained some insight about blisters and how the causes may range from a simple contact dermatitis to something potentially serious.

Please call or email us to schedule a consultation for you or your loved ones.
Thank you!

Paul K. Shitabata, M.D.
President and Medical Director
Dermatopathology Institute