Immunofluorescense of skin tissues

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Author: Mikael Häggström [notes 1]

Indications

Suspicion of one or several immunologic diseases:[1]

Suspected conditions where the direct immunofluorescence (DIF) is diagnostic:[1]

  • Bullous diseases
  • Pemphigus (all forms)
  • Pemphigoid (all forms)
  • Herpes gestationis/gestational pemphigoid
  • Dermatitis herpetiformis
  • Linear IgA bullous dermatosis Epidermolysis bullosa aquisita
  • Connective tissue diseases
  • Discoid lupus erythematosus
  • Systemic lupus erythematosus

Highly characteristic

Suspected conditions where DIF is highly characteristic and of some value:[1]

  • Vascular diseases
  • Allergic vasculitis
  • Henoch–Schoenlein purpura
  • Essential mixed cryoglobulinemia
  • Polyarteritis nodosa
  • Porphyria
  • Especially porphyria cutanea tarda
  • Lichen planus

Conditions where DIF is not diagnostic but only suggestive of immunologic pathogenesis:[1]

  • Connective tissue diseases
  • Mixed connective tissue diseases
  • Systemic sclerosis
  • Dermatomyositis
  • Psoriasis

Suspected conditions where indirect immunofluorescence is generally indicated:[1]

  • Pemphigus vulgaris
  • Pemphigus foliaceus
  • IgA pemphigus
  • Bullous pemphigoid
  • Dermatitis herpetiformis
  • Discoid lupus erythematosus
  • Disseminated DLE
  • Systemic lupus erythematosus
  • Scleroderma
  • Mixed connective tissue diseases
  • Dermatomyositis
  • Vasculitis[notes 2]
  • Porphyria[notes 2]
  • Lichen planus[notes 2]
  • ANCA associated SVV

Fixation

For example Michel's solution,[2] minimally consisting of ammonium sulfate and saline.[3]

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
  2. 2.0 2.1 2.2 Sometimes used to rule out SLE by absence of anti-nuclear antibodies in uncertain cases

References

  1. 1.0 1.1 1.2 1.3 1.4 Page 678 in: Chhabra, Seema; Minz, RanjanaWalker; Saikia, Biman (2012). "Immunofluorescence in dermatology ". Indian Journal of Dermatology, Venereology, and Leprology 78 (6): 677. doi:10.4103/0378-6323.102355. ISSN 0378-6323. Archived from the original. . 
  2. Katarzyna Lundmark, Krynitz, Ismini Vassilaki, Lena Mölne, Annika Ternesten Bratel. Handläggning av hudprover – provtagningsanvisningar, utskärningsprinciper och snittning (Handling of skin samples - Instructions for sampling, cutting and incision. KVAST (Swedish Society of Pathology). Retrieved on 2019-09-09.
  3. Niedecken, Heinz W.; Lange, Claus-Ekkehard (1985). "Simplified fixative medium for direct immunofluorescence in skin biopsies ". Journal of the American Academy of Dermatology 12 (5): 828–831. doi:10.1016/S0190-9622(85)70103-X. ISSN 01909622.