Comparison of diagnostic value of indirect immunofluorescence assay and desmoglein ELISA in the diagnosis of pemphigus.

Pemphigus vulgaris (PV) and pemphigus foliaceus (PF) are autoimmune blistering diseases characterized by intraepidermal separation as the result of autoantibodies directed to desmoglein 1 and desmoglein 3, adhesion molecules that have a pathogenic role in blister formation. Both PV and PF are diagnosed according to clinical picture, histopathologic, immunopathologic and molecular biologic features. In the present study, the value of indirect immunofluorescence (IIF) and enzyme linked immunosorbent assay (ELISA) for desmoglein 1 (Dsg 1) and desmoglein 3 (Dsg 3) at baseline visit was compared. The study was performed as a retrospective study that included 22 patients, 19 of them with PV and three with PF. Patient sera were tested with IIF and Dsg 1 and Dsg 3 ELISA. In the group of 19 PV patients, 12 patients had positive IIF, Dsg 3 and Dsg 1 ELISA; two had positive IIF and positive anti Dsg 3 but negative anti Dsg 1; three had negative IIF but positive both Dsg 1 and Dsg 3 antibodies; and two had negative IIF and Dsg 1 but positive Dsg 3 antibodies. In the group of PF patients, all three patients had positive IIF, positive Dsg 1 ELISA and negative Dsg 3 ELISA. Results of our study supported previous reports confirming Dsg 1 and Dsg 3 ELISA to be a sensitive and specific tool for the diagnosis of PV and PF.