Received Sep 1, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (PFIZER-BIONTECH)) | PFIZER\BIONTECH | 3 | FH8030 | SYR / AR |
BLISTER SORE ON HEAD DEC 2021, BLISTER AND SORE WILL NOT HEAL, JAN OR FEB 2022 BLISTER AND SORE IN MOUTH FOR FIRST TIME
DIAGNOSIS DERMATOPATHOLOGY REPORT RESULTS DIAGNOSIS: A. LEFT SCALP (SP22-3509 1) SUPRABASILAR ACANTHOLYSIS WITH OCCASIONAL INTRAEPIDERMAL EOSINOPHILS SEE COMMENT COMMENT: 1. Both biopsies A and C demonstrate a similar inflammatory pattern which is most suggestive of pemphigus vulgaris. Pemphigus vegetans was also considered due to the associated epidermal hyperplasia, but is less favored. An unusual drug hypersensitivity reaction associated with acanthosis could also be considered in the appropriate clinical setting. Correlation with the accompaning direct immunofluorescence study is recommended. 2. The specimen submitted for direct immunofluorescence has been received and the result will be reported below when completed. C. RIGHT LOWER LIP (SP22-3509 3) SUPRABASILAR ACANTHOLYSIS WITH ACUTE INFLAMMATORY SCALE CRUST AND SCATTERED EOSINOPHILS SEE COMMENT COMMENT: 1. The mucosal changes are consistent with a suprabasilar acantholytic dermatitis and compatible with the same process observed in specimen A. Correlation with the accompaning direct immunofluorescence study is recommended. Please also refer to the comment above for discussion. 2. The specimen submitted for direct immunofluorescence has been received and the result will be reported below when completed. Electronic Signature: 27 APR 2022 02:12 PM Comment: specimen #2 and #4 are DIF, the results will be added as an addendum. A copy of the original report is available in the Pathology and Laboratory Medicine Service office. SUPPLEMENTARY REPORT(S): Supplementary Report Date: MAY 02, 2022 *+* SUPPLEMENTARY REPORT HAS BEEN ADDED/MODIFIED *+* (Added/Last released: May 03, 2022 07:18) IMMUNOFLUORESCENCE REPORT RESULTS DIAGNOSIS: B. DIRECT IMMUNOFLUORESCENCE, PERILESIONAL LEFT SCALP (SP22-3509 2) POSITIVE FOR PEMPHIGUS (SEE NOTE). Note: There is linear/granular IgG deposition throughout the epithelial cell surfaces. There are also linear/granular C3 deposits on the lower two-thirds of the epithelial strata. There are no immunoreactants at the basement membrane zone and no IgA, IgM, C5b-9 or fibrinogen deposits seen in this specimen. These immunofindings are diagnostic for pemphigus, and this immunofluorescence pattern supports the diagnosis of pemphigus vulgaris over other variants. Clinical, histologic and serologic (ELISA for desmoglein 1 and 3 antibodies, Quest test code 16033) correlation is recommended as well as indirect immunofluorescence evaluation (serum) for the exclusion of paraneoplastic pemphigus if indicated. Multiple sections and immunoreactant dilutions were performed and examined. D. DIRECT IMMUNOFLUORESCENCE, PERILESIONAL RIGHT LOWER LIP (SP22-3509 4) POSITIVE FOR PEMPHIGUS (SEE NOTE). Note: There is linear/granular IgG deposition throughout the epithelial cell surfaces. There are also linear/granular C3 deposits on the lower two-thirds of the epithelial strata. There are no immunoreactants at the basement membrane zone and no IgA, IgM, C5b-9 or fibrinogen deposits seen in this specimen. These immunofindings are diagnostic for pemphigus, and this immunofluorescence pattern supports the diagnosis of pemphigus vulgaris over other variants. Clinical, histologic and serologic (ELISA for desmoglein 1 and 3 antibodies, Quest test code 16033) correlation is recommended as well as indirect immunofluorescence evaluation (serum) for the exclusion of paraneoplastic pemphigus if indicated. Multiple sections and immunoreactant dilutions were performed and examined. Electronic Signature: 29 APR 2022 09:28 AM A copy of the original report is available in the Pathology and Laboratory Medicine Service office