Test Overview
Test Methodology

Direct Immunofluorescence, Indirect Immunofluorescence for Immunomapping

Test Usage

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.

Reference Range *

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.

Test Details
Days Set Up
Monday - Friday
Analytic Time

48 hours

  • Consult
  • Surgical
  • Direct Immunofluorescence
  • 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
Specimen Requirements
Collection Instructions

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.

Skin should not be taken from heavily keratinized body areas if possible. Specialized immunofluorescence tests other than the above may be requested through the laboratory immunopathologist or immunodermatologist (contact MLabs Client Services Center).
Additional Information

Test includes pathologist interpretation of results billed as a separate additional charge or billed to the client as a global fee.

CPT Code
88346-TC 1st Ab, 88350-TC ea addl Ab
Fee Code
RA007 1st Ab, RA008 ea addl Ab
Pro Fee CPT
88346-26 1st Ab, 88350-26 ea addl Ab