Feliciani C, Pour S M, Toto P, Coscione G, Amerio P
Department of Dermatology, University "G.D'Annunzio," Chieti, Italy.
J Cutan Med Surg. 1998 Apr;2(4):209-11. doi: 10.1177/120347549800200406.
Direct immunofluorescence (DIF) is a necessary examination tool for the diagnosis of pemphigus. The suction-blister-method splits the skin at the lamina lucida and it is possible with a scalpel to separate the entire epidermis from the dermis.
The study was to determine whether DIF is reliable on epidermal sheets separated using a suction apparatus.
Thirteen patients were selected for this study: (nine with pemphigus vulgaris (PV), one with paraneoplastic pemphigus (PP), and three with pemphigus erythematosus (PE). Frozen epidermal sheets, separated from the dermis with a scalpel, were used as a substrate. Diagnosis with routine fluorescein isothiocyanate (FITC) antibodies was made.
In all patients a pericellular deposition of IgG was evident and in eight of these patients a pericellular deposition of C3 was present. In two cases of PE and one of PP, the C3 deposits were also present in the lower part of basal keratinocytes.
This diagnostic method without skin biopsy is easy to perform and, together with the histology and clinical aspects, could be a useful tool in the diagnosis of pemphigus. We recommend this method when the patient is allergic to local anaesthetics, the patient easily produces hypertrophic scars, or in follow-up of already biopsied patients.
直接免疫荧光（DIF）是天疱疮诊断的必要检查工具。吸疱法在透明层分离皮肤，用手术刀有可能将整个表皮与真皮分离。
本研究旨在确定DIF在使用抽吸装置分离的表皮片上是否可靠。
本研究选取了13例患者：9例寻常型天疱疮（PV）、1例副肿瘤性天疱疮（PP）和3例红斑型天疱疮（PE）。用手术刀从真皮分离的冷冻表皮片用作底物。采用常规异硫氰酸荧光素（FITC）抗体进行诊断。
所有患者均可见IgG的细胞周沉积，其中8例患者存在C3的细胞周沉积。在2例PE和1例PP中，基底角质形成细胞下部也有C3沉积。
这种无需皮肤活检的诊断方法易于实施，结合组织学和临床情况，可能是天疱疮诊断的有用工具。当患者对局部麻醉药过敏、容易产生肥厚性瘢痕或用于已进行活检患者的随访时，我们推荐使用这种方法。
