dermatologic disorders
Epidermolysis Bullosa Acquisita
Diagnosis of Epidermolysis Bullosa Acquisita
Skin biopsy and direct immunofluorescence Diagnosis of epidermolysis bullosa acquisita is confirmed by skin biopsy and direct immunofluorescence. Direct immunofluorescence shows linear deposits of IgG and complement at the basement membrane zone (dermal–epidermal junction). Indirect immunofluorescence using salt-split skin may be needed for differentiation from bullous pemphigoid. In the salt-split technique, a sample of healthy skin from an unaffected person is incubated withsodium chlorideto create an artificial blister. The sample is then incubated with serum from the patient and then fluorescent anti-IgG. The blister floor (dermal side) fluoresces in epidermolysis bullosa acquisita, whereas the blister roof (epidermal side) fluoresces in bullous pemphigoid. 