Diagnostic Immunopathology in 21(superscript ST) Century Dermatology Part Ⅱ: Basement Membrane and Vascular Reactions

21世紀免疫病理學在皮膚科的診斷應用Part Ⅱ：基底膜及血管反應

Maria Jasmin J. Jamora

《中華皮膚科醫學雜誌》 26卷4期 (2008/12) Pp. 191-227

https://doi.org/10.29784/DS.200812.0001

並列摘要

Immunofluorescence techniques in dermatology involve the detection of autoantibodies directed against target antigens in human skin. Direct and indirect immunofluorescence, salt split skin technique, immunoelectron microscopy and immunoblotting remain relevant and often first-line diagnostic tools. Recently developed enzyme linked immunosorbent assays (ELISA) which utilize recombinant proteins to detect serum antibodies demonstrate high sensitivity and specificity in many skin conditions. The ELISA using the NC16a domain of bullous pemphigoid antigen-2 (180 kDa) is an important adjunct tool in the diagnosis of bullous pemphigoid, mucous membrane pemphigoid, anti-epiligrin cicatricial pemphigoid, lichen planus pemphigoides and pemphigoid gestationis. The ELISA utilizing the NC1 domain of type Ⅶ collagen is relevant in the diagnosis of bullous systemic lupus erythematosus and epidermolysis bullosa acquisita. In dermatitis herpetiformis, the use of both the indirect immunofluorescence method to detect IgA anti-endomysial antibodies and the tissue transglutaminase, ELISA increases diagnostic sensitivity. In the diagnosis of necrotizing vasculitis, ELISAs using cardiolipin have been developed to detect antibodies in Henoch-Schonlein purpura, while ELISAs using proteinase-3 and myeloperoxidase were studied for the diagnosis of Wegener's granulomatosis. The differential diagnosis of other immunofluorescence patterns like cytoid bodies, epidermal nuclear fluorescence are also discussed.

並列關鍵字

Pemphigoid ； Epidermolysis bullosa acquisita ； Lichen planus ； Lupus erythematosus ； Linear IgA bullous dermatosis ； Dermatitis herpetiformis