Advances in Dermatology and Allergology
eISSN: 2299-0046
ISSN: 1642-395X
Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii
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4/2025
vol. 42
 
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abstract:
Original paper

Effectiveness of direct immunofluorescence for diagnosing autoimmune bullous diseases: data from the Central European referral department

Magdalena Jałowska
1
,
Bogusz Falkowski
1
,
Monika Bowszyc-Dmochowska
2
,
Maria Raptis-Bolwach
1
,
Justyna Gornowicz-Porowska
3
,
Agnieszka Seraszek-Jaros
4
,
Marian Dmochowski
1

  1. Autoimmune Blistering Dermatoses Section, Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
  2. Cutaneous Histopathology and Immunopathology Section, Poznan University of Medical Sciences, Poznan, Poland
  3. Department and Division of Practical Cosmetology and Skin Diseases Prophylaxis, Poznan University of Medical Sciences, Poznan, Poland
  4. Department of Bioinformatics and Computational Biology, Poznan University of Medical Sciences, Poznan, Poland
Adv Dermatol Allergol 2025; XLII (4): 373-377
DOI: https://doi.org/10.5114/ada.2025.153492
Online publish date: 2025/08/11
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Introduction:
Autoimmune bullous disorders (AIBD) are a heterogeneous group of diseases resulting from autoantibodies production. Nowadays, direct immunofluorescence (DIF) is the basic diagnostic tool for diagnosing AIBD.

Aim:
This study was performed to assess the percentages of positive and negative DIF tests performed in individuals clinically suspected to suffer from AIBD in a single Central European referral department laboratory and to propose ways to improve the effectiveness of DIF in AIBD imaging diagnostics.

Material and methods:
A total of 1985 consecutive tests were collected during 9 consecutive years (2016–2024). We analysed the total number of results, the percentages of positive and negative results year by year, and according to the unit that sent material for testing.

Results:
We found that almost one-third of the tests were positive (30.88% overall, over 9 years). The percentage of positive results has varied from year to year (from 26.22% in 2016 to 38.89% in 2023). The percentage of positive results was higher in outpatient clinics than in hospital wards (33.7% vs. 22.9%; p < 0.0001; c2 test).

Conclusions:
DIF should be performed thoughtfully at both clinical and laboratory levels, and approximately 31% of positive results should be regarded as a good outcome. To increase this percentage, specialised units should be maintained to keep up with the constant development of knowledge and experience in AIBD. Negative DIF results could also be useful in differential diagnostics of AIBD, but their percentage should be minimized.

keywords:

direct immunofluorescence, blister, pemphigus, pemphigoid, cost-benefit analysis
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