Essen%al Dermatopathology
Immunopathology
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Essen%al Dermatopathology
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Immunodermatological Diseases Epidermis
Immunopathology
BM zone
IgG
IgA
Linear/ Granular
Linear/ Granular
Pemphigus
Intraepidermal neutrophilic IgA dermatosis
IgG Linear
Epidermal side
Dermal side
Pemphigoid/ Herpes gestationis
Epidermolysis bullosa acquisita
Dermis IgA
IgA
Granular
Linear
Granular
Lupus erythematosus
Linear IgA bullous dermatosis
Papillary dermis
Vessel walls
Dermatitis herpetiformis
Henoch-Schonlein purpura
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Essen%al Dermatopathology
Immunopathology
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Essen%al Dermatopathology
Immunopathology
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Essen%al Dermatopathology
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Predominantly intraepithelial
Intercellular (cell surface)
IgG
+ BMZ
Granular IgG and/or other Ig
Pemphigus erythematosus*
Immunopathology
IgA
-‐ BMZ
Linear C3 and/or IgG
Diffuse granular
AnB-‐Ro Ab present
IgA pemphigus (intraepidermal IgA dermatosis)
Pemphigus (all forms)
ParaneoplasBc pemphigus*
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Essen%al Dermatopathology
Immunopathology
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Essen%al Dermatopathology
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Predominantly BMZ
Thick glassy linear (IgG, oTen IgA)
Finely linear
C3 only
IgG (± C3)
Pemphigoid (all forms), HG
Linear IgA dermatosis (including chronic bullous disease of childhood)
Salt split
IgG on “roof”
Pemphigoid (all forms), HG
Immunopathology
IgA
Porphyria cutanea tarda / pseudoporphyria
Granular
IgA
DermaBBs herpeBformis
≥2 Ig (lupus band)
? Lupus erythematosus
IgG on “floor”
EBA, bullous LE, rare pemphigoid
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Essen%al Dermatopathology
Immunopathology
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Essen%al Dermatopathology
Immunopathology
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Essen%al Dermatopathology
Immunopathology
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Essen%al Dermatopathology
h2p://www.interpathology.org
Roof only
Roof and base
Base only
Bullous pemphigoid (80%) Bullous pemphigoid (15%) Cicatricial pemphigoid
Cicatricial pemphigoid
Cicatricial pemphigoid
EB acquisita Linear IgA dermatosis
Linear IgA dermatosis
Linear IgA dermatosis
Bullous SLE Porphyria cutanea tarda
Immunopathology
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Essen%al Dermatopathology
Immunopathology
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Essen%al Dermatopathology
Immunopathology
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Essen%al Dermatopathology
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Predominantly vascular/ perivascular Smooth, thick IgG (±IgA) + BMZ deposits Porphyria cutanea tarda / pseudoporhyria
Immunopathology
Granular IgA
Henoch-‐ Schönlein purpura
Granular IgG
VasculiBs
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Essen%al Dermatopathology
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Granular IgA around superficial venules: Henoch-‐Schönlein purpura
Immunopathology
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Essen%al Dermatopathology
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Fibrinogen: Marker for vascular permeability only
Immunopathology
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