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<p class="ql-align-justify">Serial sections show suprabasal clefting of the epidermis with related intradermal neutrophilic infiltrate. There is associated mild dermal perivascular mononuclear inflammatory infiltrates. No evidence of specific granulomas. Picture is more consistent with IgA pemphigus.</p>
<p>White macerated erythematous plaque at submammary area, punch biopsy.</p>
<p>Four skin ellipses collectively measuring 0.7x0.6x0.3 cm, totally embedded.</p>
<p><strong><em><u>Skin Punch Biopsy:</u></em></strong></p><ul><li><strong>Suggestive of IgA pemphigus.</strong></li><li><strong>Recommended for immunofluorescence study and serological testing.</strong></li></ul><p><br></p><p><strong>COMMENT:</strong></p><h5 class="ql-align-justify">The punch biopsy from the skin plaque shows features suggestive of IgA pemphigus. For definitive diagnosis, it is recommended to perform a direct immunofluorescence (DIF) study on perilesional skin to confirm intercellular IgA deposition. Serologic testing for anti-desmocollin and anti-desmoglein IgA antibodies may provide additional supportive evidence. Clinicopathologic correlation with the lesion’s distribution, morphology, and patient history is essential to guide accurate diagnosis and appropriate management.</h5>
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