Diagnosis, diagnostic and research techniques

Abstract

The diagnosis of acquired bullous diseases is always important, as some of these disorders can be life-threatening. Although they often have definitive clinical features, the diagnosis of an acquired bullous disease is positively made both histologically and particularly by immunofluorescence (IF) techniques. However, at all times the correct diagnosis is ensured by correlating the clinical, histological and IF findings. This in turn requires a close co-operation between the clinician and the laboratory staff. Depending on the blistering condition under investigation, the clinician should biopsy a representative site which should then be properly handled and processed accordingly. Also at the time of biopsy, serum should be obtained to detect the presence or absence of circulating antibodies by the indirect immunofluorescence (IIF) method. The value of positive or negative IF findings is greatly dependent on the reliability, skill and experience of the laboratory staff carrying out these techniques and also on the knowledge of dermatopathology of the observer who reports them.