Eosinophilic Spongiosis in Vesiculo-bullous Diseases

A retrospective review of the skin biopsies of 93 patients having various vesiculo-bullous diseases seen between 1983 and 1985 revealed eosinophilic spongiosis (ES) in 31 cases. of these, 19 (36.5%) out of 52 patients having pemphigus vulgaris 2(20%) of 10 patiens having pemphigus foliaceous, one patient having pemphigus vegetans, 3 (15%) of 20 patients with bullous pemphigoid, and 3 (50%) of 6 patients with dermatitis herpetiformis had ES. The severity of eosinophilic spongiosis graded on an arbitrary scale, was 3 + in 2 cases of pemphigus vulgaris, 2 + in 7 cases of pemphigus vulgaris, 1 case of pemphigus vegetans and 2 cases of dermatitis herpetiformis, while in the remaining it was only 1 +. Only 3 patients of pemphigus vulgaris showed distinctive atypical clinical features in the form of erythema multiforme like lesions in 2 cases and erythema annulare centrifugum like lesions in 1 case. In the remaining cases the clinical presentation was not different from those who did not have ES.