Skin Biopsy for Bullous Pemphigoid
Skin Biopsy for Pemphigus Vulgaris
Skin Biopsy for Dermatitis Herpetiformis
Skin Biopsy for Linear A Disease
Skin Biopsy for Epidermolysis Bullosa Acquisita
Skin Biopsy for Herpes Gestationis
Skin Biopsy for Cicatricial Pemphigold
Skin Biopsy for Hereditary Epidermolysis Bullosa
Skin Biopsy for SLE (lupus band test)
Systemic Lupus Erythematosus (SLE) / Discoid LE (DLE)
Skin Biopsy for Cutaneous Vasculitis
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Direct Immunofluorescence, Indirect Immunofluorescence for Immunomapping
Determine the presence of immunoglobulin, complement, fibrinogen or immune complexes in tissue, in SLE (lupus band test), in the bullous diseases (dermatitis herpetiformis, linear IgA disease, Epidermolysis bullosa acquisita, Herpes gestationis, bullous pemphigoid, and pemphigus vulgaris), and in vasculitis. Determine the level of separation in hereditary epidermolysis bullosa.
No deposition of immunoglobulins, complement, or fibrinogen. Pathologist interpretation provided.
* Reference ranges may change over time. Please refer to the original patient report when evaluating results.
MLabs does not offer stain only services. Please submit the request using the MLabs Dermatopathology requisition.
Biopsy of skin or mucosa must be placed immediately into Zeus Tissue Fixative (ZTF). Take skin biopsies from the following sites: 1. If pemphigus or bullous pemphigoid, dermatitis herpetiformis, cicatricial pemphigoid, linear IgA disease, Epidermolysis bullosa acquisita, or Herpes gestationis is suspected, take a 4 mm biopsy from skin adjacent to the bullae. Repeated biopsies are sometimes necessary to confirm dermatitis herpetiformis. 2. If ocular pemphigoid is suspected, take a 4 mm punch biopsy from normal buccal mucosa or ocular conjunctiva. If systemic lupus erythematosus (SLE) or discoid LE (DLE) is suspected, take biopsy from lesional skin. 3. To differentiate between SLE and DLE, take biopsy from nonlesional nonsunexposed site such as deltoid. This biopsy which is called a lupus band test will often be positive in SLE, but should always be negative in DLE. 4. If cutaneous vasculitis is suspected, take a 4 mm punch biopsy in a new lesion of less than 24 hours duration or adjacent normal skin. 5. If immunomapping is desired for diagnosing hereditary epidermolysis bullosa, take a biopsy of a new lesion or a pencil eraser-induced lesion. Zeus Tissue Fixative is available from MLabs and a supply should be kept at the client site. Check expiration date of ZTF before use; do not use expired ZTF. Specimen in Zeus Tissue Fixative is good for up to 5 days at room temperature. DO NOT ATTEMPT TO FREEZE SPECIMENS PLACED IN ZTF.