Pathology Handbook

 New search
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z # ALL

Histology - Skin for Immunofluorescence (Sendaway Test)

Alternative Names:Skin IF
Direct Immunofloresence (skin)
Laboratory:Anatomical Pathology
Test Code:SE
Medicare rebatable:No
Specimen Types:Tissue
Container Types:
Fresh Tissue PotFresh Tissue Pot
Collection & Request Instructions:

Skin Biopsy for Immunofluorescence 

Immunofluorescence can only be performed on fresh unfixed tissue 

The fresh specimen must be wrapped in a piece of saline moistened gauze for transport to the laboratory. Wrapping prevents drying which can introduce false staining. The specimen must be delivered to the laboratory as soon as possible (within 1 hour).

If in doubt telephone the laboratory (907 62476) before removing the specimen, so that advice can be given before it is too late. 

Immunologic reactions play a major role in the pathogenesis of many skin diseases. The immunologic abnormalities found in skin and mucous membranes of patients with certain bullous (blister) disorders (pemphigus and pemphigoid), in which vesicles or bullae occur, and in the different forms of lupus erythematosus are disease specific. The distinct immunopathogenic characteristics of these diseases mean the detection of deposits of immunoglobulin and complement components in both lesional and normal skin by direct immunofluorescent techniques is of great value in establishing a diagnosis.

The extracellular antigens of most value in immunodermatology are IgA, IgG, IgM, the complement proteins (C3C, C4 & C1q) and fibrinogen. The immunoreactivity of these antigens is deleteriously affected by formalin fixation to varying degrees.

Skin Biopsy Specimen Collection

Whenever possible, biopsy a single fresh small blister including adjacent clinically uninvolved skin (perilesional).

>      For a large blister, biopsy edge of blister and adjacent uninvolved skin (perilesional).

>     Cut the perilesional end and send for IF studies and the remaining blister for histology.

>     For uninvolved skin, a 3-mm punch biopsy is sufficient.

 

Condition

Biopsy Site(s) for IF

Pemphigus (All forms)

Perilesional Uninvolved (Buttock)

Pemphigoid (All forms)

Perilesional Uninvolved (Thigh or Arm)

Pemphigoid (Herpes) Gestationis

Perilesional

Linear IgA Bullous Dermatoses (LAD & CBDC)

Perilesional Uninvolved (Buttock)

Epidermolysis Bullosa Acquisita

Perilesional

Discoid Lupus Erythematosus

Lesional

Systemic Lupus Erythematosus

Lesional & Uninvolved(Non-sun exposed [Buttock])

Bullous Systemic Lupus Erythematosus

Perilesional

Dermatitis Herpetiformis

Uninvolved (Buttock)

Lichen Planus

Lesional

Porphyria

Lesional

Vasculitis

Lesional

Amyloid

Lesional

Transport Instructions:Send to lab immediately
External Laboratory:The Alfred Pathology Service (APS)
  External Laboratory details...