Original article / research
A Two Year Retrospective Study of Direct Immunofluorescence in Autoimmune Vesiculobullous Lesions with Clinical Correlation
Dr. Sarojini Raman,
Department of Pathology, KIMS, Campus-5, Bhubaneswar-751024, Odisha, India.
Introduction: Autoimmune bullous lesions are diverse group of diseases characterised by blisters in the skin with or without mucosal lesions. They present with great degree of clinical and histopathological overlap; hence, advanced immunological methods like direct and indirect immunofluorescence techniques have become essential for accurate diagnosis in most of these cases.
Aim: To study the pattern, intensity of immunofluorescence among various autoimmune vesiculobullous lesions with clinical correlation.
Materials and Methods: This present study was a retrospective one in which 36 cases of vesiculobullous lesions were included. In Direct Immuno Fluorescence (DIF) the type of immunoglobulin expressed, pattern of deposition and its intensity was noted. Statistical method was used to calculate percentages, ratio, sensitivity and specificity.
Results: The mean age in the study group was 46.2 years (SD±17.9) with male to female ratio 1.2:1. Most common lesion was pemphigus vulgaris in 12 (33.3%) cases. Most common site of the lesions were trunk 11 cases (30.5%), followed by upper extremity in 8 cases (22.2%). Only in 8 (22.2%) cases histopathological correlation was done. DIF was positive in 31 cases (86.1%). IgG was present in 25 (69.4%) patients, C3 was positive in 14 (38.8%) cases and IgM was present in 6 (16.6%) patients. DIF was inconclusive in 5 (13.8%) cases. Intensity of 3+ IgG was seen in 2 (16.6%) cases of pemphigus vulgaris followed by 2+ intensity in 5 (41.6 %) cases. C3 was positive in 14 (38.8%) cases with 2+ expression seen in 4 (30.4%) cases.
Conclusion: DIF is a helpful diagnostic test in autoimmune vesiculobullous lesions even in absence of histopathological correlation.
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