A Young boy presents with multiple flaccid bullous lesions over trunk with some oral mucosal lesions. Most likely finding on immunofluorescence study of the biopsy specimen would be:
Ans. A. 'Fishnet' IgG deposits in epidermis Pemphigus vulgarisBullous PemphigoidAutoantibodies againstDesmosomal proteinsHemidesmosomal proteinsAge40-60 yrs60-75 yrsInitial siteOral mucosaLower extremitiesBullaeFlaccidTensePruritusMild/-Nonexistent or severeNikolsky's sign+-Mucosal involvement+(in almost all patients)- (10-40% only)HPESuprabasal acantholytic blisters (Tombstone appearance)Subepidermal blisters(eosinophil rich dermal infiltrate)DIFIgG & C3 deposits at intercellular substance of epidermis ("Fishnet appearance")IgG, C3, and IgA/IgM at BM zone.IIFCirculating IgG antibodies to intercellular substance of epidermis.Anti-BM zone antibodies IgGRxQSteroids + immunosuppressantsDapsoneGoldSteroidsImmunosuppressantsDapsonePost inflammatory Hyperpigmentation+-
'Fishnet' IgG deposits in epidermis
Linear IgG in Deposits
Linear IgA in dermal papillae
Granular IgA in reticular dermis
Vesiculobullous (Blistering) Disorders