Histopathology of autoimmune bullous dermatoses: what's new?

Abstract

Autoimmune bullous dermatoses are characterized by the presence of tissue-bound and often circulating pathogenic autoantibodies targeting structural components of the skin and/or mucous membranes. The diagnostic workup for this heterogeneous group of disorders consists of a multi-step process, of which the light microscopic examination is a crucial component. This review is organized following a classification scheme that is based on two main histopathologic features, namely level of intraepithelial split and composition of the inflammatory infiltrate. Overall, we aim to place emphasis on the histopathologic clues that can assist pathologists in differential diagnosis and review the updates in the literature.

Keywords: Acantholysis; Autoimmune bullous; Dermatitis herpetiformis; Direct immunofluorescence; Immunobullous; Linear IgA bullous dermatosis; Pemphigoid; Pemphigus.