Biopsy location for direct immunofluorescence in patients with suspected bullous pemphigoid impacts probability of a positive test result.

Abstract:

BACKGROUND:Bullous pemphigoid (BP) is an autoimmune polymorphic skin disease characterized by erythematous papules and plaques and tense bullae. A skin biopsy for direct immunofluorescence (DIF) is used to detect autoantibodies and complement proteins. OBJECTIVE:We sought to determine which location would provide the highest probability of obtaining a positive DIF result. METHOD:We undertook a retrospective chart review of 1,423 DIF biopsies. Biopsies with a clinical suspicion of BP were designated as either lesional, perilesional, or indeterminate. RESULTS:Fifty percent of lesional DIF biopsies were positive, whereas 22% of perilesional and 12% of indeterminate biopsies had a positive DIF result. The odds ratio of a positive DIF from a lesional versus perilesional biopsy site was found to be 3.45 (95% CI 1.44-8.29). CONCLUSION:Clinicians are more likely to obtain a positive DIF result from a lesional nonbullous skin biopsy than from a perilesional or normal skin biopsy.

journal_name

J Cutan Med Surg

authors

Sladden C,Kirchhof MG,Crawford RI

doi

10.2310/7750.2014.14004

subject

Has Abstract

pub_date

2014-11-01 00:00:00

pages

392-6

issue

6

eissn

1203-4754

issn

1615-7109

journal_volume

18

pub_type

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