Zaenglein A L, Hafer L, Helm K F
Department of Medicine, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey, USA.
Arch Dermatol. 1995 May;131(5):571-3.
Immunofluorescence detection of stippled IgA in dermal papillae has been considered the gold standard in the diagnosis of dermatitis herpetiformis (DH). We have developed an immunohistochemical technique using the avidin-biotin-peroxidase complex that is equally effective as direct immunofluorescence in detecting IgA. We retrospectively studied 43 paraffin-embedded biopsy specimens obtained from patients with DH and a variety of other diseases for the presence of IgA along the basement membrane zone.
Eleven immunofluorescence-proved cases of DH were found positive for IgA with the avidin-biotin-peroxidase method. One biopsy specimen originally classified as DH was identified and reclassified as linear IgA bullous disease based on the immunoperoxidase findings. All the samples that were positive on direct immunofluorescence were positive with the avidin-biotin-peroxidase method. Control samples of bullous pemphigoid, discoid lupus erythematosus, pemphigus vulgaris, and dermatitis were all negative for IgA deposition.
The diagnosis of DH on formalin-fixed tissue is possible with the use of an avidin-biotin-peroxidase method, which is convenient and cost-effective.
真皮乳头中斑点状IgA的免疫荧光检测一直被视为疱疹样皮炎（DH）诊断的金标准。我们开发了一种使用抗生物素蛋白-生物素-过氧化物酶复合物的免疫组织化学技术，该技术在检测IgA方面与直接免疫荧光同样有效。我们回顾性研究了43例从DH患者及其他多种疾病患者获取的石蜡包埋活检标本，以检测基底膜带是否存在IgA。
采用抗生物素蛋白-生物素-过氧化物酶方法，在11例经免疫荧光证实的DH病例中发现IgA呈阳性。根据免疫过氧化物酶检查结果，1例最初分类为DH的活检标本被重新鉴定并归类为线状IgA大疱性疾病。所有直接免疫荧光呈阳性的样本，采用抗生物素蛋白-生物素-过氧化物酶方法检测也呈阳性。大疱性类天疱疮、盘状红斑狼疮、寻常型天疱疮和皮炎的对照样本IgA沉积均为阴性。
使用抗生物素蛋白-生物素-过氧化物酶方法可对福尔马林固定组织进行DH诊断，该方法方便且经济有效。
