Cutaneous lupus erythematosus: comparison of direct immunofluorescence findings with histopathology. 1995

A R al-Suwaid, and M N Venkataram, and S R Bhushnurmath
Department of Dermatology, Al Nahdha Hospital, Muscat, Sultanate of Oman.

BACKGROUND Direct immunofluorescence (DIF) is considered to be a major advance in the diagnosis of connective tissue diseases, particularly lupus erythematosus (LE); however, the reliability of the technique depends on several factors, such as age and site of the lesion, type of immunofluorescence, type of immunoglobulin, etc. False positives and false negatives can occur. OBJECTIVE To determine the diagnostic value of DIF we studied 18 clinically established cases of cutaneous lupus erythematosus (CLE). Lesional biopsies were subjected to routine histopathologic examination and direct immunofluorescence. The results were compared. RESULTS Direct immunofluorescence was positive in 72.7% and histopathology in 66% cases. Combination of the two techniques (with one or both methods giving characteristic findings) was positive in 83% cases. The most common antibody was IgG, seen in 77.8% cases. A homogeneous pattern of immunofluorescence, with IgG, was seen in 55.5% of the cases. Although histopathology gave positive or suggestive results in all cases, DIF was negative in two cases of early cutaneous LE. CONCLUSIONS Although DIF is an extremely useful diagnostic tool, it should always be used in conjunction with histopathology and the combination of the two methods yields the best results.

UI MeSH Term Description Entries
D007136 Immunoglobulins Multi-subunit proteins which function in IMMUNITY. They are produced by B LYMPHOCYTES from the IMMUNOGLOBULIN GENES. They are comprised of two heavy (IMMUNOGLOBULIN HEAVY CHAINS) and two light chains (IMMUNOGLOBULIN LIGHT CHAINS) with additional ancillary polypeptide chains depending on their isoforms. The variety of isoforms include monomeric or polymeric forms, and transmembrane forms (B-CELL ANTIGEN RECEPTORS) or secreted forms (ANTIBODIES). They are divided by the amino acid sequence of their heavy chains into five classes (IMMUNOGLOBULIN A; IMMUNOGLOBULIN D; IMMUNOGLOBULIN E; IMMUNOGLOBULIN G; IMMUNOGLOBULIN M) and various subclasses. Globulins, Immune,Immune Globulin,Immune Globulins,Immunoglobulin,Globulin, Immune
D008178 Lupus Erythematosus, Cutaneous A form of lupus erythematosus in which the skin may be the only organ involved or in which skin involvement precedes the spread into other body systems. It has been classified into three forms - acute ( Lupus Erythematosus, Cutaneous, Subacute,Lupus Erythematosus, Subacute Cutaneous,Cutaneous Lupus Erythematosus
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D005260 Female Females
D006651 Histocytochemistry Study of intracellular distribution of chemicals, reaction sites, enzymes, etc., by means of staining reactions, radioactive isotope uptake, selective metal distribution in electron microscopy, or other methods. Cytochemistry
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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