Laboratory diagnosis of autoimmune blistering skin diseases

Autoimmune blistering skin diseases are a group of organ-specific autoimmune disorders that are characterized by autoantibodies against desmosome and hemidesmosome which are structural proteins of the epidermis or the dermal-epidermal junction and clinically by blisters and erosions on skin and/or mucous membranes. According to the skin level at which the blister occurs and the structural proteins that the autoantibodies target, autoimmune blistering diseases can be categorized into intraepithelial blister group and subepidermal blister group. The treatment options and prognosis are different among the various diseases. Since clinical criteria and histopathological characteristics are not sufficient for an accurate diagnosis of autoimmune blistering skin diseases, direct immunofluorescence microscopy, indirect immunofluorescence microscopy, ELISA, immunoblotting and immunoprecipitation are needed for exact diagnosis. The detection of serum autoantibodies have been shown to correlate with disease activity and thus may be helpful in deciding treatment options for the patients.(Chin J Lab Med, 2015, 38: 797-800) Key words: Autoimmune diseases; Skin diseases, vesiculobullous; Autoantibodies; Immunoassay