A study on plucked hair as a substrate for direct immunofluorescence in pemphigus vulgaris

Abstract

Regarding the relatively high sensitivity of DIF on plucked hair in PV patients with positive oral mucosal DIF in our study, it seems that hair plucking is a suitable alternative to the more invasive techniques of skin or mucosal biopsy for obtaining specimens for DIF in PV.

Direct immunofluorescence of plucked hair for evaluation of immunologic remission in pemphigus vulgaris

“…10 Recently, in a study in our center, the sensitivity of hair DIF in 110 patients with untreated PV and positive DIF on oral mucosal biopsy specimen was found to be 91%. 6 In another study with a different DIF method (without freezing the hair) from India, a sensitivity of 85% was reported in active pemphigus. 7 In this study we compared plucked hair DIF and conventional DIF to assess immunologic remission.…”

“…The value of this method was proven in further studies on patients with untreated or relapsed pemphigus. 6,7 The current study was undertaken to compare ORS DIF in patients with pemphigus vulgaris (PV) in clinical remission with conventional DIF, to assess the immunologic remission.…”

Direct immunofluorescence for immunobullous and other skin diseases

“…An investigation on a subset of pemphigus patients who were proved positive for DIF test in perilesional skin biopsies has announced a 100% detection of immunoreactants, and consequently this was unconditional of the presence of scalp lesions [21]. Another one has calculated a sensitivity of approximately 91% for DIF of plucked hair in pemphigus patients (n = 110) with positive DIF result of oral mucosa samples [22]. Contrary to this, less is suggested to use DIF of hair as an alternative of conventional DIF for immunological follow-up of PV patients [23].…”

Immunofluorescence in dermatology

“…[26] The pemphigus-specific immunofluorescence pattern seen in the skin has also been demonstrated in the outer root sheaths of plucked hair follicles in 85-100% cases of PV. [28][29][30][31][32] The role of DIF techniques on Tzanck smear samples has also been evaluated for the diagnosis of PV, and the results were found to be comparable with respective skin biopsies in the same set of patients. [33] Thus, Tzanck smears can serve as an alternative to surgical biopsies especially in rural areas lacking proper histological equipment.…”