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Pathology, immunopathology, and immunohistochemistry in cutaneous lupus erythematosus

The diagnosis of cutaneous lupus erythematosus (LE) generally requires clinicopathologic correlation, necessitating routine histologic examination of lesional skin. Direct immunofluorescence (DIF) of lesional skin is an adjunctive test, which can help confirm the diagnosis of cutaneous LE. DIF is particularly helpful in situations where routine histologic findings are equivocal, and in lesions of scarring alopecia. DIF of non-lesional skin (the lupus band test, LBT) is occasionally performed in the evaluation of patients with suspected systemic lupus erythematosus (SLE). A positive LBT in non-lesional, sun protected skin may correlate with the presence of renal disease, and thus provide prognostic as well as diagnostic information. More recently, immunohistochemical techniques have been used to determine the nature of inflamma-