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. 2019 Nov-Dec;94(6):724-728.
doi: 10.1016/j.abd.2019.02.002. Epub 2019 Oct 26.

Diagnostic approach of eosinophilic spongiosis

Karina Lopes Morais  1 , Denise Miyamoto  2 , Celina Wakisaka Maruta  2 , Valéria Aoki  2
Affiliations

Diagnostic approach of eosinophilic spongiosis

Karina Lopes Morais et al. An Bras Dermatol. 2019 Nov-Dec.

Abstract

Eosinophilic spongiosis is a histological feature shared by some distinct inflammatory disorders, and is characterized by the presence of intraepidermal eosinophils associated with spongiosis. Most often, isolated eosinophilic spongiosis indicates the early stages of a subjacent autoimmune bullous dermatosis, such as the pemphigus group and bullous pemphigoid. Herein, the main causes of eosinophilic spongiosis are discussed, as well as the supplementary investigation needed to elucidate its etiology.

Keywords: Diagnosis, differential; Eosinophils; Pemphigoid, bullous; Pemphigus; Skin diseases, vesiculobullous.

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Figures

Figure 1
Figure 1
Clinical presentation of pemphigus herpetiformis (A). Annular urticarial plaques (B) and peripheral vesicles (C) in herpetiformis pattern on posterior trunk.
Figure 2
Figure 2
Pemphigus herpetiformis. (A) Eosinophilic spongiosis, without prominent acantholysis (Hematoxylin & eosin, x400). (B) Direct immunofluorescence with linear, intercellular, and intraepithelial IgG deposits.
Figure 3
Figure 3
Urticarial (A) and bullous (B) phases of bullous pemphigoid.
Figure 4
Figure 4
Bullous pemphigoid. (A) Focal eosinophilic spongiosis adjacent to subepidermal clefting (Hematoxylin & eosin, x400). (B) Direct immunofluorescence with linear deposits of IgG in the basement membrane zone.
Figure 5
Figure 5
Diagnostic management of eosinophilic spongiosis. DIF, direct immunofluorescence; (−), negative; (+), positive; BP, bullous pemphigoid; MMP, mucous membrane pemphigoid; PG, pemphigoid gestationis.
See this image and copyright information in PMC

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