Diagnostic pemphigoid testing

Test	Specimen	Site	Procedure	Transport
Histopathology (H&E)	Skin or mucous membrane	Lesional or part lesional	At least 4 mm punch biopsy* Specimen should contain intact epidermis/epithelium, basement membrane zone, and upper dermis/subepithelium Avoid torsion and crushing to prevent separation artifact	In formalin to a dermatopathology laboratory
DIF	Skin or mucous membrane	Perilesional For cutaneous lesions, an erythematous or urticarial area next to a blister from a proximal anatomical location is ideal For mucous membrane lesions, avoid areas of scarring; normal-appearing epithelium since perilesional tissue may be friable	At least 4 mm punch biopsy* Specimen should contain intact epidermis/epithelium, basement membrane zone, and upper dermis/subepithelium Avoid torsion and crushing to prevent separation artifact	In Michel's or Zeus medium to an immunodermatology laboratory^¶
IIF and ELISA	Serum	Peripheral blood	Serum separated from at least 5 mL of blood obtained by venipuncture (red top, no anticoagulant); send serum separated from clot^Δ	In serum tube to an immunodermatology laboratory

If questions about specimen site selection or acceptable specimen handling conditions, contact an immunodermatology laboratory.

H&E: hematoxylin and eosin; DIF: direct immunofluorescence; IIF: indirect immunofluorescence; ELISA: enzyme-linked immunosorbent assay.
* An alternative to 2 biopsies, 1 each for H&E histopathology examination and DIF, as indicated above, is to obtain one 5 or 6 mm punch biopsy or one deep shave biopsy specimen that contains both lesional and perilesional tissue. The specimen is split into 2 pieces with a scalpel. Care should be taken to avoid disrupting the epidermis or crushing the specimen during splitting. The lesional portion is placed in formalin for H&E histology, and the perilesional portion is placed in Michel's or Zeus transport medium for DIF.
¶ Some immunodermatology laboratories will accept tissue on saline-saturated gauze if it is transported to the laboratory within 6 hours (the sooner the better and to be received during working hours) and will also accept tissue specimens that are flash frozen and transported on dry ice.
Δ The serum can be separated without a centrifuge by allowing whole blood to clot in a tube for 30 minutes to 2 hours. The serum on top of the clotted blood is then carefully transferred into a serum tube with a disposable pipette and sent to an immunodermatology laboratory. Alternatively, some immunodermatology laboratories accept whole blood if it is transported to the laboratory promptly (within 6 hours).

Graphic 57402 Version 6.0

خرید پکیج

Diagnostic pemphigoid testing