Direct Immunofluorescence for Dermatologic Disorders:A Single-Center Retrospective Analysis for 11 Years
- Author:
Dong-Wha YOO
1
;
Jang-Hoon YI
;
Kyung-Deok PARK
;
Hyeok-Jin KWON
;
Ki-Ho KIM
;
Jung-Ho YOON
Author Information
1. Department of Dermatology, Dong-A University College of Medicine, Busan, Korea
- Publication Type:Original Article
- From:Korean Journal of Dermatology
2024;62(1):18-28
- CountryRepublic of Korea
- Language:EN
-
Abstract:
Background:Direct immunofluorescence (DIF) is a histochemical technique used to detect tissue-bound autoantibodies and diagnose various immune-mediated skin diseases.
Objective:This study aimed to evaluate the sensitivity of DIF for each disorder, and the consistency between clinical, histopathological, and DIF results.
Methods:A retrospective study was conducted in 194 patients who underwent skin biopsy and DIF testing at our hospital between January 2011 and December 2021. An antibody panel against immunoglobulin G (IgG), IgA, IgM, C3, C1q, and fibrinogen was used. The concordance rate and κ-coefficient between the clinical, histopathological, and DIF results were evaluated.
Results:DIF was observed to be positive in 87 cases; 51 cases of immune-mediated bullous diseases, seven cases of connective tissue diseases (CTDs), 25 cases of vasculitis, and four cases of other diseases. The overall sensitivity of DIF for immune-mediated bullous diseases was 71.8%, which was higher than that of histopathology (64.8%). In CTDs and vasculitis, the overall sensitivities of DIF were 30.4% and 65.8%, respectively, which were lower than those of histopathology (73.9% and 84.2%, respectively). In addition, good concordance among the clinical, histological, and DIF results was observed.
Conclusion:DIF is a useful diagnostic method, especially for immune-mediated bullous diseases, lupus erythematosus, and Henoch-Schonlein purpura. However, in other CTDs and vasculitis cases, the sensitivity of DIF is relatively low. Therefore, the diagnostic value of DIF along with clinical and histopathological findings will be maximized only when the DIF test is performed for appropriate diseases.
