Dermatopathology

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Bullous Pemphigoid

Bullous pemphigoid is an autoimmune vesiculobullous disorder whereby the pathogenesis is caused by autoantibodies to components of the basement membrane of the skin namely BP antigen 180 (type XVII collagen and the most frequent antigenic target) and BP antigen 230 (component of the hemidesmosome).

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Slide 1: A 90 year old male patient presents with blisters on the trunk, arms, skin, and scalp. There is frank detachment of the epidermis from the dermis in the biopsy specimen.

Slide 2: The separation of the epidermis from the dermis occurs at a subepithelial level reflecting an autoimmune response to hemidesmosomal proteins.

Slide 3: The epidermis has undergone degenerative changes, and the blister cavity contains eosinophils and lymphocytes.