Comparision of direct immunofluorescence of plucked hair and skin for valuation of immunological remission in pemphigus

Manu Vidhya, H (2016) Comparision of direct immunofluorescence of plucked hair and skin for valuation of immunological remission in pemphigus. Masters thesis, PSG Institue of Medical Sciences and Research, Coimbatore.


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Demonstration of intercellular deposition of IgG on the cell surface of keratinocytes by DIF of perilesional skin is the gold standard in diagnosis of Pemphigus. DIF of plucked hair demonstrating intercellular space deposition of IgG in the outer root sheath(ORS) has shown to be a useful test with sensitivity ranging from 85-100%. AIM AND OBJECTIVE: Our objective was to compare DIF of plucked hair and skin for evaluation of immunological remission in patients with clinical remission. METHODOLOGY: 30 patients of Pemphigus who showed positive DIF of skin and hair at baseline were included in the study. DIF of skin and hair was repeated after 6 months or more of clinical remission (with no new /non healing lesions). Presence of intercellular space deposits of IgG and or C3 in skin and ORS of hair was considered positive. RESULTS: Out of 30 patients � Both skin and hair DIF was positive in 8, � Both hair and skin DIF was negative in 14, � DIF skin was positive and hair was negative in 2 patients and � DIF of hair was positive and skin negative in 6 patients. CONCLUSION: DIF of hair and skin correlated with each other in 22 (73.3%) patients and sensitivity of hair DIF was 70% and specifity was 80%. The sensitivity was not high enough to suggest that it could replace the use of skin or mucosal DIF for assessment of immunological remission. However, in 6 (20%) patients the positivity of hair DIF in spite of skin being negative cannot be disregarded. Hence, this could be a recommended additional procedure to assess immunological remission as it is non-invasive and cost effective.

Item Type: Thesis (Masters)
Uncontrolled Keywords: immunofluorescence ; Plucked Hair and Skin ; Immunological Remission ; Pemphigus.
Subjects: MEDICAL > Dermatology Venereology and Leprosy
Depositing User: Punitha K
Date Deposited: 28 Jul 2017 07:52
Last Modified: 01 Mar 2018 02:19

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