To the Editor.—
Judd and Lever1 reported on "Correlation of Antibodies in Skin and Serum With Disease Severity in Pemphigus." They concluded that "indirect IF [immunofluorescence], contrary to statements in the literature, is unreliable for evaluating the status of the disease or for gauging therapy in some patients with pemphigus."The authors base their conclusion on IF tests of patients' serum samples using guinea pig esophagus sections as antigenic substrate, which they justify on the basis of data reported by Judd and Mescon.2 With this test system, they find that 45% of their patients who were free of lesions (some without treatment) had detectable titers of intercellular antibodies.
Chorzelski TP, Jablonska S, Jarzabek-Chorzelska M, Beutner EH, Nisengard RJ, Kumar V, Jordan RE, Michel B. Reliability of Indirect Immunofluorescence Testing. Arch Dermatol. 1980;116(11):1228. doi:10.1001/archderm.1980.01640350018006