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(12) A step out of the dark: frozen section immunohistochemistry in the diagnosis of autoimmune skin diseases
Author(s) -
Kirkham N.,
Price M.L.,
Darley C.R.,
Gibson B.R.,
Chippendale K.
Publication year - 1987
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/j.1365-2133.1987.tb12030.x
Subject(s) - immunoperoxidase , frozen section procedure , medicine , pemphigus , pathology , immunofluorescence , autoantibody , pemphigoid , direct fluorescent antibody , dermatology , immunology , antibody , monoclonal antibody , bullous pemphigoid
For many years, immunofluorescent techniques have provided a reliable way of identifying immune complexes in frozen sections of skin biopsies in the diagnosis of autoimmune skin diseases. Of course, immunofluorescence requires a darkened room and a special microscope, and the fluorescence may fade quickly. As a consequence, this important part of the diagnostic process has not been universally applied. Attempts have been made to use immunoperoxidase on paraffin sections as an alternative but without much success, mainly because of the problems of excessive background reactivity and decreased specific‐staining sensitivity. We have used standard immunoperoxidase and avidin‐biotin complex methods on frozen sections to produce a result which combines the advantages of high sensitivity, previously only available with immunofluorescence, with a result which can be evaluated on a standard transmitted light microscope. We illustrate the technique with biopsies from patients with pemphigus, pemphigoid and pemphigus gestationis. The preparations do not fade with time and it is therefore possible to demonstrate the results at clinico‐pathological meetings and to undertake retrospective reviews for other purposes. The high sensitivity of the avidin‐biotin complex is especially successful in this application. With these straightforward techniques, autoimmune skin diseases can be adequately characterized in routine laboratories.