Original Article

Direct Immunofluorescence Study in Discoid Lupus Erythematosus

Reema Bhushan, Shilpi Agarwal, Ram Chander and Kiran Agarwal
World Journal of Pathology 2017, 6:10

Abstract

Background

Diagnosis of a classical case of Discoid lupus erythematosus (DLE) is generally clinical. However, histopathological study of skin biopsy is helpful to confirm the diagnosis in early DLE lesions and in DLE variants. There is however paucity of large studies on its direct immunofluorescence (DIF) findings in India.

Patients and Methods

The study was conducted in the Department of Pathology on 34 clinically suspected cases of DLE who presented in the Department of Dermatology, Venereology &Leprosy at Smt. Sucheta Kriplani Hospital from 2012 to 2014.

Results

Histopathological diagnosis of DLE could be made in 30/34 (88.2%) cases while 4/34 (11.8%) cases showed non specific findings on histopathology. These four cases showed positive lupus band test on DIF examination, hence rendering the diagnosis of DLE. DIF was positive in 30/34 (85.3%) cases at the dermoepidermal junction (DEJ) in the form of lupus band test (LBT) in the lesional skin biopsy. The majority of cases showed deposit of multiple immunoreactants at DEJ (61.7% cases) with combined positivity for IgM plus IgG in 7/34 (20.6%) cases. Five cases (14.8%) cases in addition also showed DIF positivity in the dermal blood vessel (DBV) wall.

Conclusions

Direct immunofluorescence is a useful diagnostic technique in the diagnosis of DLE. However, it should be used in conjunction with histopathology.

Key Words

Direct immunofluorescence, Discoid lupus erythematosus, Lupus band test.

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