Back issues No.3 - 2000 / Case Report  

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Blister Fluid for the Diagnosis of Bullous Pemphigoid: Experience in 3 Cases
Ya-Yi Chang, Roger Chin-Che Hsu, Gwo-Shin Chen, Yuh-Lan Suen, Hsin-Su Yu
Dermatol Sinica 18: 185-190, 2000

Bullous pemphigoid (BP) and other subepidermal autoimmune bullous diseases such as cicatricial pemphigoid, pemphigoid gestationis, linear IgA bullous dermatosis and epidermolysis bullosa acquisita are characterized by the presence of circulating and/or in situ deposition of autoantibodies to self-antigens in the cutaneous basement membrane zone. Direct and indirect immunofluorescent studies are routine diagnostic tests to detect autoantibodies in these diseases. In this study, we compared the titers of IgG antibodies in serum and in aspirated blister fluid from three patients with BP by indirect immunofluorescence on both the intact and salt-split skins. Compared with the antibody titer in serum, the titer in blister fluid was the same or at one dilution difference in these three patients. Our finding shows that blister fluid might be used as an alternative to serum in the study of patients with BP. This avoids the need for venesection and has a practical application in children and those with poor venous access.

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