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Journal Scan / Research · June 26, 2020

Diagnostic Performance of DIF Microscopy Studies by Biopsy Sites in Autoimmune Subepidermal Blistering Dermatoses

The British Journal of Dermatology

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• Forty-three patients with autoimmune blistering diseases were included in this study, of which 40 had bullous pemphigoid, 2 had epidermolysis bullosa aquisita, and 1 had linear IgA bullous dermatosis. Biopsies from both normal-appearing skin within 2 cm of a blister and from erythematous nonblistered skin were obtained from each patient and submitted for direct immunofluorescence (DIF) testing. There was no significant difference in DIF positivity between adjacent normal-appearing skin (83.7%) and erythematous nonblistered skin (74.4%). There was also no difference between normal versus erythematous skin for rates of linear deposition of IgG (72.1% vs 62.8%), IgA (14.3% for both), C3 (74.4% vs 69.8%), or IgE (10% vs 12.5%).

• A biopsy from either site for DIF should aid in the diagnosis of autoimmune blistering disease.

– Caitlyn T. Reed, MD

Abstract

The diagnosis of autoimmune subepidermal blistering diseases, such as bullous pemphigoid (BP), critically relies on the detection of tissue-bound immunoreactants along the epidermal basement membrane by direct immunofluorescence microscopy (DIF) studies of skin biopsy specimens obtained from perilesional skin 1,2. However, there was surprisingly no consensus among international experts about the definition of perilesional skin 1. The latter was considered as either normal appearing skin surrounding an inflamed area or erythematous skin adjacent to a blister.

The British Journal of Dermatology

Diagnostic Performance of Direct Immunofluorescence Microscopy Studies by Biopsy Sites in Autoimmune Subepidermal Blistering Dermatoses: A Prospective Study

Br J Dermatol 2020 Jun 07;[EPub Ahead of Print], S Haefliger, S Sitaru, S Cazzaniga, A Rammlmair, L Feldmeyer, MP Horn, L Borradori 

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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