Utility of Direct Immunofluorescence in diagnosis of non – infectious / immune mediated diseases involving skin – Tertiary center

• Author Details:   
• Mahak Jain
• Amit Varma
• Gaurav Sharad Pawar ^*
• Garima Malpani

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Background:  Skin biopsy in Auto immune bullous and other immune mediated disorders are valuable for diagnosis but and additional test which may lead to get a better understanding of the disease likewise DIF and Indirect  immunofluorescence could help clinicians as well pathologist to access more. To understand the Patterns and intensity shown by different disorders this method is of valuable tool.
Materials and Methods: An Ambispective study was conducted in the Department of Pathology in our hospital during a 28 month period extending from January 2022 to April 2024. Material for this study included two samples of biopsy, one for histopathology and one for DIF of 80 patients who clinically presented with autoimmune bullous disease, connective tissue disease or vasculitis from Department of Dermatology of our hospital.
Results: In the present study total 80 cases were studied, which were suspected as immune mediated skin disorders out of which 40 (50%) cases belonged to pemphigus group, 21(26.2%) cases of bullous group, 10 (12.5%) cases belonged to vasculitis disorders, 3 (3.7%) cases of connective tissue disorders and 6 (7.5%) cases were taken as miscellaneous which were either suspected as pemphigus/bullous/vasculitis/CTD in the period between January 2022 and April 2024.
Conclusion: DIF is a useful supplement in the accurate diagnosis of autoimmune mediated skin disorders. A negative DIF result helps to rule out the immunological cause of the skin disorder. In cases with inconclusive clinical features and histopathology, DIF acts as a confirmatory as well as diagnostic in immune mediated disorders. A combined analysis of clinical features, histopathology and DIF is required for an accurate diagnosis. A combination of investigations by a direct immunofluorescence and histological examination remains the gold standard in the diagnosis of immune mediated disorders.

Keywords: Biopsy, Direct immunofluorescence, Indirect, BMZ, ICS.