A cross-sectional study of direct immunofluorescence in the diagnosis of immunobullous dermatoses

Buch, Archana; Kumar, Harsh; Panicker, N K; Misal, Sonali S; Sharma, Yugal K; Gore, Charusheela

doi:10.4103/0019-5154.135488

Cited by 30 publications

(29 citation statements)

References 12 publications

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“…This was in concordance to study by Buch et al which showed 100% of cases having granular IgA deposition at dermal papillae. 7 Present study showed 100% cases of PF having IgG deposition and 66.7% showing additional C3 deposition also. Study by Deepti et al showed 75% of cases having only IgG deposition and 25% having both IgG and C3 deposition.…”

Section: Type Of Antibodies Deposition On Dif In Vesiculobullous Lesionssupporting

confidence: 56%

“…6 Study by Buch et al described majority (18/25) of BP showing linear IgG and C3 deposition in the basement membrane zone (BMZ). 7 In our study 100% cases of DH showed IgA deposition and 20% of the cases showed additional C3 deposition. This was in concordance to study by Buch et al which showed 100% of cases having granular IgA deposition at dermal papillae.…”

Section: Type Of Antibodies Deposition On Dif In Vesiculobullous Lesionssupporting

confidence: 52%

“…This is in accordance with a study by Kabir et al who found the mean age of 35.1±19.4 years whereas study by Buch et al described mean age of 57 years. 6,7 Females were affected slightly more than the males. This finding was similar to the previous study by Deepti [3][4][5][6]8,9 In the present study, BP was common in older individuals with mean age of 60.2 years which is similar to that reported by Selvaraj et al 10 The mean age of presentation in patients of PV in present study was 42 years.…”

Section: Age and Sex Distributionmentioning

confidence: 99%

“…6 According to a study conducted by Buch et al, DIF is a very reliable diagnostic test for pemphigus, which becomes positive at an early stage and remains positive for a long period after clinical remission. 7 In the absence of the characteristic DIF pattern, the combination of clinical, histologic, and immunologic data is needed to support the definite diagnosis of different immunobullous disorders.…”

Section: Clinical Histopathological and Dif Correlationmentioning

confidence: 99%

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A study of clinicopathologic spectrum of vesicobullous disorders

et al. 2017

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Background: Blistering diseases are alarming skin conditions. Autoimmune blistering diseases are a group of bullous disorders characterized by pathogenic antibodies directed at the target antigens in the epidermis or dermoepidermal junction.The objectives were to study the spectrum of histopathological changes by light microscopy, to evaluate the pattern of direct immunofluorescence (DIF) and to correlate clinical, histopathological features and DIF findings of vesiculobullous lesions of the skin or/and mucosa.Methods: The present study was carried out on 110 skin and/or mucosal biopsies with vesicobullous disorders from July 2013 to June 2016. Detailed clinical history, morphology of lesions, site of involvement and other findings were recorded as per proforma. These cases were analysed clinically, histopathologically and on immunofluorescence.Results: Majority of the patients presented in the age group of 41-50 years (30.9%). The male: female ratio was 1:1.15. Pemphigus vulgaris was the most common vesiculobullous disorder constituting 48.2%, followed by Bullous Pemphigoid constituting 27.3%. Dermatitis herpetiformis constituted 8.3%; Pemphigus foliaceous 3.6%, varicella and Stevens Johnson Syndrome both were observed in 2.7% each. DIF was performed in 81 cases out of which only 72 cases (92.6%) showed positivity. Conclusions: DIF is a sensitive tool for distinguishing immune mediated bullous diseases from other vesiculobullous disorders especially in cases which pose a diagnostic dilemma both clinically and histologically. The final diagnosis depends on correlation of clinical, histopathological and immunoflourescence findings.

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Section: Type Of Antibodies Deposition On Dif In Vesiculobullous Lesionssupporting

confidence: 56%

Section: Type Of Antibodies Deposition On Dif In Vesiculobullous Lesionssupporting

confidence: 52%

Section: Age and Sex Distributionmentioning

confidence: 99%

Section: Clinical Histopathological and Dif Correlationmentioning

confidence: 99%

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A study of clinicopathologic spectrum of vesicobullous disorders

et al. 2017

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“…In the case, that DIF is done during the treatment by immunosupresives, the results of DIF can be negative. Negative immunofl uorescence may be viewed as the state of immunological remission in pemphigus (26).…”

Section: Discussionmentioning

confidence: 99%

A study of clinical, histopathological and direct immunofluorescence diagnosis in pemphigus group Utility of direct immunofluorescence

Hrabovska¹,

Jautová²,

Hrabovsky³

2017

BLL

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AIMS: To determine the diagnostic accordance between histopathological and direct immunofl uorescence diagnosis of patients with autoimmune vesiculobullous skin diseases. BACKGROUND: The term pemphigus refers to a group of autoimmune blistering diseases mediated by autoantibodies directed against desmoglein proteins. The differentiation between the various bullous diseases is important for treatment and prognosis. Direct immunofl uorescence microscopy is still the gold standard in differentiating these diseases. METHODS: Patients with clinical diagnosis of vesiculobullous dermatitis from pemphigus group were included in the study. We retrospectively analyzed histopathologic and direct immunofl uorescence results from skin or mucosal samples over 15-year period. RESULTS: 81 patients were included. The accordance was good in pemphigus vulgaris and pemphigus herpetiformis, but low in pemphigus vegetans, pemphigus foliaceus and pemphigus erythematosus. No accordance was in Hailey-Hailey disease and Grover´s disease. Uncommon result in our analysis included: intraepidermal IgG and IgM depositions at DIF in one Grover´s disease patient. CONCLUSION: Our results confi rmed the relevance of direct immunofl uorescence assays as a necessary diagnostic method for the defi nitive diagnosis of autoimmune blistering disease in the case, where the clinical feature and the results of histopathology are not clear (Tab. 4, Fig. 5, Ref. 26). Text in PDF www.elis.sk.

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Autoimmune Subepidermal Bullous Diseases of the Skin and Mucosae: Clinical Features, Diagnosis, and Management

Amber

Murrell

Schmidt

et al. 2017

Clinic Rev Allerg Immunol

171

191

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Autoimmune subepidermal blistering diseases of the skin and mucosae constitute a large group of sometimes devastating diseases, encompassing bullous pemphigoid, gestational pemphigoid, mucous membrane pemphigoid, epidermolysis bullosa acquisita, and anti-p200 pemphigoid. Their clinical presentation is polymorphic. These autoimmune blistering diseases are associated with autoantibodies that target distinct components of the basement membrane zone of stratified epithelia. These autoantigens represent structural proteins important for maintenance of dermo-epidermal integrity. Bullous pemphigoid (BP) is the most common subepidermal autoimmune blistering disease of the skin and mucosae. Although the disease typically presents with a generalized blistering eruption associated with itch, atypical variants with either localized bullous lesions or "non-bullous" presentations are observed in approximately 20% of patients. A peculiar form of BP typically associated with pregnancy is pemphigoid gestationis. In anti-p200 pemphigoid, patients present with tense blisters on erythematosus or normal skin resembling BP, with a predilection for acral surfaces. These patients have antibodies targeting the 200-kDa basement membrane protein. Epidermolysis bullosa is a rare autoimmune blistering disease associated with autoantibodies against type VII collagen that can have several phenotypes including a classical form mimicking dystrophic epidermolysis bullosa, an inflammatory presentation mimicking BP, or mucous membrane pemphigoid-like lesions. Mucous membrane pemphigoid (MMP) is the term agreed upon by international consensus for an autoimmune blistering disorder, which affects one or more mucous membrane and may involve the skin. The condition involves a number of different autoantigens in the basement membrane zone. It may result in severe complications from scarring, such as blindness and strictures. Diagnosis of these diseases relies on direct immunofluorescence microscopy studies and immunoserological assays. Management of affected patients is often challenging. We will here review the clinical and immunopathological features as well as the pathophysiology of this group of organ-specific autoimmune diseases. Finally, we will discuss the diagnostic approach and the principles of management in clinical practice.

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A cross-sectional study of direct immunofluorescence in the diagnosis of immunobullous dermatoses

Cited by 30 publications

References 12 publications

A study of clinicopathologic spectrum of vesicobullous disorders

A study of clinicopathologic spectrum of vesicobullous disorders

A study of clinical, histopathological and direct immunofluorescence diagnosis in pemphigus group Utility of direct immunofluorescence

Autoimmune Subepidermal Bullous Diseases of the Skin and Mucosae: Clinical Features, Diagnosis, and Management

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