Diseases
Immunodermatology tests are important in diagnosing the following.
Follow the links for images of typical test results and biopsy site selection instructions.
- Celiac disease
- Cutaneous vasculitis (including Henoch-Schonlein purpura)
- Dermatitis herpetiformis
- Drug reaction
- Eosinophil-associated disease
- Epidermolysis bullosa acquisita
- Lichen planus and lichenoid reactions
- Linear IgA bullous dermatosis
- Lupus erythematosus (all types)
- Mixed connective tissue disease
- Pemphigoid (all types)
- Pemphigus (all types)
- Porphyria and pseudoporphyria
- Urticaria
Celiac Disease
[disease images]
Serum IgA endomysial antibodies and tissue transglutaminase antibodies (serum IgG antibodies if IgA deficient).
Cutaneous vasculitis: (including Henoch-Schönlein purpura)
[disease images]
Skin biopsy (fresh lesion) for direct immunofluorescence.
Dermatitis herpetiformis
[disease images]
Skin biopsy (perilesional skin) for direct immunofluorescence and serum IgA endomysial antibodies and tissue transglutaminase antibodies (serum IgG antibodies if IgA deficient). For initial diagnosis, recommend: total IgA, IgA EMA, and IgA tTg; if IgA is low, IgG EMA and IgG tTg. To monitor disease activity/adherence to gluten restricted diet, recommend following EMA and/or tTg titers.
Skin biopsy (fresh lesion) for direct immunofluorescence.
Eosinophil-associated disease
[disease images]
Skin or other organ biopsy and/or serum for eosinophil-granule major basis protein.
Epidermolysis bullosa acquisita
[disease images]
Skin biopsy (perilesional) for direct immunofluorescence and serum for indirect immunofluorescence (IgG basement membrane zone antibodies).
Lichen planus and lichenoid reactions
[disease images]
Skin biopsy (fresh lesion) for direct immunofluorescence.
Linear IgA bullous dermatosis and chronic bullous disease of childhood
[disease images]
Skin biopsy (perilesional) for direct immunofluorescence and serum for indirect immunofluorescence (IgA basement membrane zone antibodies).
Lupus erythematosus
[disease images]
Skin biopsy (fresh lesion) for direct immunofluorescence; for bullous lupus erythematosus, also serum for indirect immunofluorescence (basement membrane zone antibodies).
Discoid lupus erythematosus
Systemic lupus erythematosus
Subacute cutaneous lupus erythematosus
Mixed connective tissue disease
Skin biopsy (fresh lesion) for direct immunofluorescence.
Pemphigoid
[disease images]
Skin biopsy (perilesional) for direct immunofluorescence and serum for indirect immunofluorescence (IgG basement membrane zone antibodies) and ELISA for IgG BP 180 and BP 230 antibodies.
Bullous pemphigoid
Cicatricial pemphigoid:
Anti-epiligrin cicatricial pemphigoid
Brunsting-Perry pemphigoid
Ocular pemphigoid
Mucous membrane pemphigioid
Gestational pemphigoid, herpes gestationis or pemphigoid gestationis (also serum for herpes gestationis factor)
Pemphigus
[disease images]
Skin biopsy (perilesional) for direct immunofluorescence and serum for indirect immunofluorescence (IgG cell surface antibodies) and ELISA for IgG desmoglein 1 and desmoglein 3 antibodies.
Pemphigus vulgaris
Pemphigus vegetens
Pemphigus foliaceus
Pemphigus erythematosus
Paraneoplastic pemphigus (also serum for paraneoplastic screen)
IgA pemphigus (also serum for IgA cell surface)
Porphyria and pseudoporphyria
[disease images]
Skin biopsy for direct immunofluorescence.
Urticaria
[disease images]
Skin biopsy for direct immunofluorescence.
