Indirect cutaneous immunofluorescence. II. Clinical significance.

Sera of 532 patients with bullous diseases, connective tissue diseases and malignancies were tested for pemphigus epidermal intercellular fluorescence (ICF) and for the bullous pemphigoid ;tubular' band by the indirect fluorescent antibody technique. Human normal skin cryostat sections were used. The band and ICF were seen primarily only in bullous pemphigoid and pemphigus respectively, Some indirect band and ICF-negative patients demonstrated positive direct results in involved skin. suggesting that direct tests should be performed in indirect negative patients clinically thought to have pemphigus or bullous pemphigoid. No close correlation was found between disease activity and positive or negative indirect tests in bullous pemphigoid and pemphigus. Steroids did not interfere with positive results of this diagnostically extremely valuable test.